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Lehmler S, Siehl S, Kjelkenes R, Heukamp J, Westlye LT, Holz N, Nees F. Closing the loop between environment, brain and mental health: how far we might go in real-life assessments? Curr Opin Psychiatry 2024; 37:301-308. [PMID: 38770914 DOI: 10.1097/yco.0000000000000941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
PURPOSE OF REVIEW Environmental factors such as climate, urbanicity, and exposure to nature are becoming increasingly important influencers of mental health. Incorporating data gathered from real-life contexts holds promise to substantially enhance laboratory experiments by providing a more comprehensive understanding of everyday behaviors in natural environments. We provide an up-to-date review of current technological and methodological developments in mental health assessments, neuroimaging and environmental sensing. RECENT FINDINGS Mental health research progressed in recent years towards integrating tools, such as smartphone based mental health assessments or mobile neuroimaging, allowing just-in-time daily assessments. Moreover, they are increasingly enriched by dynamic measurements of the environment, which are already being integrated with mental health assessments. To ensure ecological validity and accuracy it is crucial to capture environmental data with a high spatio-temporal granularity. Simultaneously, as a supplement to experimentally controlled conditions, there is a need for a better understanding of cognition in daily life, particularly regarding our brain's responses in natural settings. SUMMARY The presented overview on the developments and feasibility of "real-life" approaches for mental health and brain research and their potential to identify relationships along the mental health-environment-brain axis informs strategies for real-life individual and dynamic assessments.
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Affiliation(s)
- Stephan Lehmler
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Sebastian Siehl
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | | | - Jannik Heukamp
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
| | - Lars Tjelta Westlye
- Department of Psychology, University of Oslo
- Center for Precision Psychiatry, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Nathalie Holz
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Frauke Nees
- Institute of Medical Psychology and Medical Sociology, University Medical Center Schleswig-Holstein, Kiel University, Kiel, Germany
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Čepić S, Tomićević-Dubljević J, Pálsdóttir AM. Unveiling human-nature interaction: Qualitative exploration of perceived benefits of urban gardening. Health Place 2024; 88:103276. [PMID: 38768548 DOI: 10.1016/j.healthplace.2024.103276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 05/22/2024]
Abstract
The study seeks to provide insights into the subjective experiences and perceived benefits of urban gardening by gardeners in the city of Belgrade. It encompassed several forms of urban gardens, both collective and individual. The study involved conducting semi-structured interviews with 44 gardeners, supplemented by field observations. Thematic analysis revealed seven key themes of benefits. The findings slightly diverged from studies in developed countries, demonstrating less emphasis on the social aspects of urban gardening, as participants did not view social interaction as a primary motivation. Also, there was a stronger focus on the productive and economic aspects of gardening among the retired low-income population of home gardeners with previous experience in agriculture.
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Affiliation(s)
- Slavica Čepić
- University of Belgrade - Faculty of Forestry, Department of Landscape Architecture and Horticulture, Kneza Višeslava 1, 11030, Belgrade, Serbia.
| | - Jelena Tomićević-Dubljević
- University of Belgrade - Faculty of Forestry, Department of Landscape Architecture and Horticulture, Kneza Višeslava 1, 11030, Belgrade, Serbia.
| | - Anna María Pálsdóttir
- Swedish University of Agricultural Sciences, Faculty of Landscape Architecture, Horticulture and Crop Production Science, Department of People and Society, PO Box 190, SE-234 22, Lomma, Sweden.
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Lau SSS, Fong JWL, van Rijsbergen N, McGuire L, Ho CCY, Cheng MCH, Tse D. Emotional responses and psychological health among young people amid climate change, Fukushima's radioactive water release, and wars in Ukraine and the Middle East, and the mediating roles of media exposure and nature connectedness: a cross-national analysis. Lancet Planet Health 2024; 8:e365-e377. [PMID: 38849179 DOI: 10.1016/s2542-5196(24)00097-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 04/10/2024] [Accepted: 04/25/2024] [Indexed: 06/09/2024]
Abstract
BACKGROUND New global crises are emerging, while existing global crises remain unabated. Coping with climate change, the radioactive water released into the Pacific Ocean subsequent to the Fukushima nuclear accident in Japan, and the wars in Ukraine and the Middle East (hereafter referred to as the wars) as individual crises can negatively affect the psychological health of young people, but little is known about the compounded impact of multiple crises. We aimed to examine: (1) the emotional responses of young people towards each individual crisis, (2) how aggregate levels of emotional engagement in global crises might pose different potential trajectories in psychological health, and (3) the protective or exacerbating role of media exposure and nature connectedness as mediators on psychological health outcomes of young people. METHODS We conducted a cross-national online survey among young people (aged 18-29 years) from China, Portugal, South Africa, the USA, and the UK. We adopted stratified purposive sampling and distributed the survey using online platforms (www.wenjuan.com and www.prolific.com). Individuals were eligible for inclusion in our analysis if they were literate in Chinese or English and had no mental disorders diagnosed within the past 12 months. Participants were asked questions on their demographic characteristics and time spent on social media, including proportion of time exposed to media pertaining to global crises of interest, and they completed surveys based on validated scales that measure depression, anxiety, stress, and wellbeing, as well as emotional responses to each global crisis and nature relatedness. We assessed the survey results using descriptive statistics, ANOVA tests, cluster analysis for individual emotional responses, and structural equation modelling for the aggregate measure of emotional engagement towards individual global crises. FINDINGS Between Oct 20 and Nov 3, 2023, 2579 individuals participated in the survey, of whom 400 participants from each country (200 male and 200 female participants) were included in our analysis (mean age 24·36 years [SD 2·86]). The mean emotional engagement varied between the global crises of interest (on a scale from 0 to 68, where 0 indicates no emotional response and 68 indicates strong emotional responses across 17 different emotions; wars: 32·42 [SD 14·57]; climate change: 28·79 [14·17]; radioactive water: 21·26 [16·08]), and emotional engagement also varied by country; for instance, for respondents from China, mean emotional engagement in radioactive water was relatively high (39·15 [10·72]) compared with the other countries, and for respondents from the USA, engagement with the wars was relatively low (29·45 [15·78]). We found significant variations in the level of emotional engagement between different crises, with distinct emotional profiles observed among individual countries. To assess the role of media exposure and nature connectedness on psychological outcomes, using structural equation modelling, we constructed a multi-country model comprising Portugal, South Africa, the USA, and the UK, and a standalone model for China. These models elucidated associations between emotional engagement and psychological distress and wellbeing, explaining substantial portions of the variance in both. Notably, while greater emotional engagement in the ecological crises (ie, climate change and radioactive water) generally predicted worse psychological health outcomes, we found the direction of effect for war crises to have positive outcomes for mental health in the standalone China model. Additionally, we found that media exposure mediated the negative effect of wars on psychological distress in the multi-country model, and positive psychological wellbeing in the standalone China model. Moreover, nature connectedness emerged as a potent mediator, effectively mitigating the adverse mental health effects of emotional engagement with some crises, such as radioactive water and climate change. INTERPRETATION Our findings offer valuable insights into the nuanced dynamics of emotional engagement in global crises and its implications for mental health outcomes among young people across diverse global contexts. Further research is needed to understand the contribution of ongoing and new global crises towards a compounded negative future outlook on young people's mental health to identify effective communication and intervention strategies that can mitigate the effect of this global challenge. FUNDING Research Grants Council of Hong Kong, China.
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Affiliation(s)
- Sam S S Lau
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China; College of International Education, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China.
| | - Jason W L Fong
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China
| | | | - Laura McGuire
- Department of Psychology, Edge Hill University, Ormskirk, UK
| | - Cherry C Y Ho
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China; Division of Nursing Education, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China
| | - Marco C H Cheng
- Research Centre for Environment and Human Health, School of Continuing Education, Hong Kong Baptist University, Hong Kong Special Administrative Region, China
| | - Dorothy Tse
- Department of Psychology, Edge Hill University, Ormskirk, UK
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Martin L, White MP, Elliott LR, Grellier J, Astell-Burt T, Bratman GN, Lima ML, Nieuwenhuijsen M, Ojala A, Roiko A, van den Bosch M, Fleming LE. Mechanisms underlying the associations between different types of nature exposure and sleep duration: An 18-country analysis. ENVIRONMENTAL RESEARCH 2024; 250:118522. [PMID: 38403148 DOI: 10.1016/j.envres.2024.118522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 01/17/2024] [Accepted: 02/17/2024] [Indexed: 02/27/2024]
Abstract
Whilst green space has been linked to healthier sleep outcomes, the roles of specific types of nature exposure, potential underlying mechanisms, and between-country variations in nature-sleep associations have received little attention. Drawing on cross-sectional survey data from an 18-country sample of adults (N = 16,077) the current study examined: 1) the relative associations between six different types of nature exposure (streetscape greenery, blue view from home, green space within 1 km, coast within 1 km, green space visits, blue space visits) and insufficient sleep (<6 h vs. 7-10 h per day); 2) whether these relationships were mediated by better mental wellbeing and/or physical activity; and 3) the consistency of these pathways among the different countries. After controlling for covariates, neighbourhood nature measures (green space, coast within 1 km) were not significantly associated with insufficient sleep; but nature visible from home (streetscape greenery, blue views) and recreational visits to green and blue spaces were each associated with less insufficient sleep. Significant nature-sleep associations were mediated, to varying degrees, by better mental wellbeing, but not self-reported physical activity. Country-level heterogeneity in the strength of nature-sleep associations was observed. Increasing nature visible from the home may represent a promising strategy for promoting healthier sleep duration at the population level, whilst nature-based interventions encouraging individuals to spend time in local green/blue spaces may be an appropriate target to assist individuals affected by insufficient sleep.
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Affiliation(s)
- Leanne Martin
- European Centre for Environment and Human Health, University of Exeter Medical School, UK.
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, UK; Cognitive Science HUB & Urban and Environmental Psychology Group, University of Vienna, Austria
| | - Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter Medical School, UK
| | - James Grellier
- European Centre for Environment and Human Health, University of Exeter Medical School, UK; Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Thomas Astell-Burt
- Population Wellbeing and Environment Research Lab (PowerLab), NSW, Australia; School of Health and Society, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, Australia
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, USA
| | - Maria L Lima
- Department of Social and Organizational Psychology, ISCTE - University Institute of Lisbon, Portugal
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ann Ojala
- Natural Resources Institute Finland (Luke), Finland
| | - Anne Roiko
- School of Pharmacy & Medical Sciences, Griffith University, Australia
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; Natural Resources Institute Finland (Luke), Finland; School of Population and Public Health, University of British Columbia, Canada; Department of Forest and Conservation Sciences, University of British Columbia, Canada
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, UK
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Damasceno da Silva RM, Andreotti Dias M, Rodrigues Ferreira Barbosa V, Jablinski Castelhano F, James P, Requia WJ. Greenness and Hospitalization for Cardiorespiratory Diseases in Brazil. ENVIRONMENTAL HEALTH PERSPECTIVES 2024; 132:67006. [PMID: 38889165 DOI: 10.1289/ehp13442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2024]
Abstract
BACKGROUND The potential health benefits of exposure to vegetation, or greenness, are well documented, but there are few nationwide studies in Brazil, a country facing challenges related to land-use planning, deforestation, and environmental health risks. OBJECTIVES In this study, we investigated the association between greenness and hospitalizations for cardiorespiratory diseases in Brazil. METHODS We accessed hospital admissions data from 967,771 postal codes (a total of 26,724,624 admissions) covering Brazil for the period between 2008 and 2018. We used Normalized Difference Vegetation Index (NDVI) data from the Moderate Resolution Imaging Spectroradiometer (MODIS) to measure greenness at the postal-code level. First, we applied a quasi-Poisson regression model to estimate the association between greenness and hospitalizations for circulatory and respiratory diseases, adjusted for air pollution, weather variables, and area-level socioeconomic status. We stratified the analyzes by sex, age group, health outcome, and Brazilian regions. In the second stage, we performed a meta-analysis to estimate pooled effects across the Brazilian regions. RESULTS The national meta-analysis for the whole population, incorporating both urban and nonurban areas, showed that higher levels of greenness were associated with a lower risk of hospitalizations for circulatory diseases. An interquartile range (IQR = 0.18 ) increase in average NDVI was associated with a 17% (95% confidence interval: 8%, 27%) lower risk of cardiovascular admissions. In contrast, there was no association found between greenness and respiratory admissions. When specifically examining urban areas, the results remained consistent with the overall findings. However, the analyses of nonurban areas revealed divergent results, suggesting that higher levels of greenness in rural regions are associated with a lower risk of hospital admissions for both circulatory and respiratory diseases. DISCUSSION The findings emphasize the importance of prioritizing the preservation and creation of green spaces in urban areas as a means of promoting cardiovascular health in Brazil. https://doi.org/10.1289/EHP13442.
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Affiliation(s)
- Reizane Maria Damasceno da Silva
- Center for Environment and Public Health Studies, School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Brazil
| | - Mariana Andreotti Dias
- Center for Environment and Public Health Studies, School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Brazil
| | | | | | - Peter James
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
- Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Weeberb J Requia
- Center for Environment and Public Health Studies, School of Public Policy and Government, Fundação Getúlio Vargas, Brasília, Brazil
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Li J, Trivic Z. Impact of "blue-green diet" on human health and wellbeing: A systematic review of potential determinants in shaping the effectiveness of blue-green infrastructure (BGI) in urban settings. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 926:171397. [PMID: 38438033 DOI: 10.1016/j.scitotenv.2024.171397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 02/12/2024] [Accepted: 02/28/2024] [Indexed: 03/06/2024]
Abstract
Discourses concerning the potential health benefits of blue-green infrastructure (BGI) have gained momentum, highlighting its positive influence on human health and wellbeing. While studies have explored the concept of "Nature Pyramid" and the role of exposure to natural environments in promoting health, the role of water elements remains underexplored. Rooted in this concept, this study proposed a notion of "blue-green diet" as a framework to understand the intricate mechanisms and determinants of optimal blue-green exposure. Understanding the relationship between these determinants and their health-related impacts can facilitate the enhancement of BGI design, leading to greater effectiveness in promoting health and wellbeing and supporting sustainable urban development strategies. To enhance the comprehension of the "blue-green diet", this study conducted a systematic literature review to grasp the underlying mechanisms behind its beneficial effects, focusing on two key determinants of "blue-green diet", which are also derived from the concept of the "Nature Pyramid": (1) the type of BGI and (2) the mode of interaction with and within BGIs. Under the search of BGI's overall health impacts, this study selected 54 journal publications concerning BGI's type and interaction mode from Web of Science and Scopus since 2010. The review revealed significant disparities in the health benefits provided by different types of BGI (in terms of artificial extent and scale) and between active and passive interaction modes. It examines how to balance natural and artificial elements for enhancing the benefits of BGI and discusses the attributes of BGI that encourage diverse and meaningful interaction patterns. These efforts collectively aim to optimize BGI design and planning, increase its capacity to promote health, and extend its benefits to a wider range of individuals. Future research should encompass a broader spectrum of determinants, such as diverse BGI settings, visit frequency and duration, and user's social-cultural backgrounds.
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Affiliation(s)
- Jingyi Li
- Department of Architecture, National University of Singapore, 4 Architecture Drive, Singapore 117566.
| | - Zdravko Trivic
- Department of Architecture, National University of Singapore, 4 Architecture Drive, Singapore 117566.
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Hammoud R, Tognin S, Smythe M, Gibbons J, Davidson N, Bakolis I, Mechelli A. Smartphone-based ecological momentary assessment reveals an incremental association between natural diversity and mental wellbeing. Sci Rep 2024; 14:7051. [PMID: 38627422 PMCID: PMC11021539 DOI: 10.1038/s41598-024-55940-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/29/2024] [Indexed: 04/19/2024] Open
Abstract
Using smartphone-based ecological momentary assessment, this study investigated an association between natural diversity on mental wellbeing. A sample of 1,998 participants completed 41,448 assessments between April 2018 and September 2023. Environments which included a larger range of natural features, such as trees, plants and birdlife (high natural diversity) were associated with greater mental wellbeing than environments including a smaller range of natural features (low natural diversity). There was evidence of a mediating effect of natural diversity on the association between natural environments and mental wellbeing. These results highlight the importance of policies and practices that support richness of biodiversity for public mental health.
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Affiliation(s)
- Ryan Hammoud
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK.
| | - Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
| | - Michael Smythe
- Nomad Projects, Sunbury Workshops, 24, Swanfield St, London, E2 7LF, UK
| | | | | | - Ioannis Bakolis
- Health Services and Population Research Department, Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, SE5 8AF, UK
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Zhang R, Chen H, Liu L, Wang F, Yang Z. Unraveling the longitudinal relationships between connectedness to nature, depressive symptoms, and learning burnout in adolescents. J Adolesc 2024. [PMID: 38622930 DOI: 10.1002/jad.12330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 04/04/2024] [Accepted: 04/05/2024] [Indexed: 04/17/2024]
Abstract
INTRODUCTION Following the conservation of resource theory and natural stress reduction theory, the current study investigated mediated pathways, reverse mediated pathways, and reciprocal pathways between connectedness to nature, depressive symptoms, and adolescent learning burnout via a half-longitudinal analysis, and discussed gender differences in the three models. METHODS Two waves of data were collected in December 2022 (T1) and June 2023 (T2) for this study. The sample consisted of 1092 Chinese adolescents (52.20% girls, Mage = 13.03, SD = 1.43). Semi-longitudinal analyses were conducted to examine the relationship between connectedness to nature, depressive symptoms, and adolescent academic burnout. RESULTS The results indicated that connectedness to nature can serve as a positive resource to alleviate the levels of depressive symptoms among adolescents and thereby decrease learning burnout. However, the protective effect of connectedness to nature was smaller, and the decreasing effect of learning burnout on connectedness to nature was stronger than the alleviating effect of connectedness to nature on learning burnout. Additionally, the study found that depressive symptoms and academic burnout have a mutually reinforcing effect over time and that the effects of this interaction are more pronounced in females. CONCLUSIONS The present study emphasizes the protective role of nature connectedness and the detrimental effects of learning burnout in adolescents.
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Affiliation(s)
- Rentao Zhang
- College of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Hui Chen
- College of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
| | - Li Liu
- Hong'an Middle School, Chongqing, China
| | | | - Zhihui Yang
- College of Humanities and Social Sciences, Beijing Forestry University, Beijing, China
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Lyshol H, Johansen R. The association of access to green space with low mental distress and general health in older adults: a cross-sectional study. BMC Geriatr 2024; 24:329. [PMID: 38600442 PMCID: PMC11007904 DOI: 10.1186/s12877-024-04738-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 01/23/2024] [Indexed: 04/12/2024] Open
Abstract
BACKGROUND Access to green space is considered beneficial to mental and physical health, though the causal pathways are not completely clear. Accordingly, the objective of this study was to examine how access to green space was associated with low mental distress and general health among older adults. METHODS The data in our study stems from a survey from three Norwegian counties in 2015-16, n = 2937. The main exposure variable was self-reported access to green space, and the outcome variables were self-reported mental distress and general health. Logistic regression adjusted for sex, age, education, physical activity, functional disability, access to cultural/sports facilities and economic security was performed to assess the association between the exposure variable and the outcome variables. RESULTS Access to green space was associated with both higher odds of low mental distress (Odds Ratio = 3.85**, 95% CI 2.04-6.02) and good general health (OR = 8.20**, 95%CI 5.88-11.49) compared to no access. In models adjusted for sex, age, and education, the ORs were only slightly changed (OR = 4.03**, 95%CI 2.52-6.45) and (OR = 7.91**, 95%CI 5.63-11.13). However, adjusting for general health with low mental distress as outcome, the association was no longer statistically significant; (OR = 1.28 95%CI 0.74-2.21). Adjusting for low mental distress with general health as outcome, the association remained statistically significant; (OR = 3.43** 95%CI 2.34-5.03). CONCLUSIONS Our findings suggest that the association between access to green space and mental health may be mediated by general health. This implies that studies of associations between access to green space and mental health must take general health into consideration.
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Affiliation(s)
- Heidi Lyshol
- Department of Health and Inequality, Norwegian Institute of Public Health, Oslo, Norway.
| | - Rune Johansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, Oslo, Norway
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10
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Nicklett EJ, Sharma BB, Testa A. Physical Activity and Local Blue/Green Space Access During the COVID-19 Pandemic. Am J Health Promot 2024:8901171241244892. [PMID: 38580226 DOI: 10.1177/08901171241244892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
PURPOSE To examine whether local blue and green space access was associated with weekly physical activity frequency during the COVID-19 pandemic. DESIGN Cross-sectional. SETTING Population-based, nationally representative sample of U.S. adults (May and June 2021). SAMPLE Adults, ages 18-94 (N = 1,771). MEASURES Self-reported data included the presence of blue spaces (e.g., lakes, outdoor swimming pools, riverside trails) and green spaces (e.g., parks, forests, or natural trails) in their neighborhoods, and days of physical activity per week (e.g., running, swimming, bicycling, lifting weights, playing sports, or doing yoga). ANALYSIS Multiple Poisson regression assessed relationships between blue and green spaces and physical activity, with coefficients transformed into incidence risk ratios (IRR). RESULTS Among participants, 67.2% reported living near a blue space and 86.1% reported living near a green space. Racial/ethnic and socioeconomic disparities in access to blue and green spaces were observed, with less access among non-Hispanic Black participants and those with lower income and educational attainment. Living near blue (IRR = 1.23, 95% CI = 1.10, 1.39) or green space (IRR = 1.25, 95% CI = 1.02, 1.54) was significantly associated with more frequent weekly physical activity. CONCLUSION Proximity to blue or green spaces is associated with more frequent physical activity during the COVID-19 pandemic. Health promotion efforts should include equitable strategies to improve accessibility to blue and green spaces.
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Affiliation(s)
- Emily J Nicklett
- Department of Social Work, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, USA
| | - Bonita B Sharma
- Department of Social Work, College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, USA
| | - Alexander Testa
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
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11
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Robinson JM, Breed AC, Camargo A, Redvers N, Breed MF. Biodiversity and human health: A scoping review and examples of underrepresented linkages. ENVIRONMENTAL RESEARCH 2024; 246:118115. [PMID: 38199470 DOI: 10.1016/j.envres.2024.118115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/09/2023] [Accepted: 01/04/2024] [Indexed: 01/12/2024]
Abstract
Mounting evidence supports the connections between exposure to environmental typologies(such as green and blue spaces)and human health. However, the mechanistic links that connect biodiversity (the variety of life) and human health, and the extent of supporting evidence remain less clear. Here, we undertook a scoping review to map the links between biodiversity and human health and summarise the levels of associated evidence using an established weight of evidence framework. Distinct from other reviews, we provide additional context regarding the environment-microbiome-health axis, evaluate the environmental buffering pathway (e.g., biodiversity impacts on air pollution), and provide examples of three under- or minimally-represented linkages. The examples are (1) biodiversity and Indigenous Peoples' health, (2) biodiversity and urban social equity, and (3) biodiversity and COVID-19. We observed a moderate level of evidence to support the environmental microbiota-human health pathway and a moderate-high level of evidence to support broader nature pathways (e.g., greenspace) to various health outcomes, from stress reduction to enhanced wellbeing and improved social cohesion. However, studies of broader nature pathways did not typically include specific biodiversity metrics, indicating clear research gaps. Further research is required to understand the connections and causative pathways between biodiversity (e.g., using metrics such as taxonomy, diversity/richness, structure, and function) and health outcomes. There are well-established frameworks to assess the effects of broad classifications of nature on human health. These can assist future research in linking biodiversity metrics to human health outcomes. Our examples of underrepresented linkages highlight the roles of biodiversity and its loss on urban lived experiences, infectious diseases, and Indigenous Peoples' sovereignty and livelihoods. More research and awareness of these socioecological interconnections are needed.
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Affiliation(s)
- Jake M Robinson
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia.
| | - Andrew C Breed
- Epidemiology and One Health Section, Department of Agriculture, Water, and the Environment, Canberra, ACT, Australia; School of Veterinary Science, University of Queensland, Gatton, Qld, Australia
| | | | - Nicole Redvers
- Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Martin F Breed
- College of Science and Engineering, Flinders University, Bedford Park, SA, Australia
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12
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Hooyberg A, Roose H, Lonneville B, De Henauw S, Michels N, Everaert G. Survey data linking coastal visit behaviours to socio-demographic and health profiles. Sci Data 2024; 11:315. [PMID: 38538625 PMCID: PMC10973510 DOI: 10.1038/s41597-024-03161-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/19/2024] [Indexed: 04/01/2024] Open
Abstract
Coastal destinations are highly popular for leisure, yet the effects of spending time at the coast on mental and physical health have remained underexplored. To accelerate the research about the effects of the coast on health, we compiled a dataset from a survey on a sample (N = 1939) of the adult Flemish population about their visits to the Belgian coast. The survey queried the number of days spent at the coast in the previous year or before and the following characteristics of their visits: how often they performed specific activities, which of the 14 municipal seaside resorts they visited, who they were with, what they mentally and physically experienced, and what reasons they had for not visiting the coast more often. The respondents' geo-demographic (including residential proximity to the coast), socio-economic, and health profile was also collected. We anticipate that investigations on the data will increase our understanding about the social structuring of coastal visits and give context to the effects of the coast on human health.
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Affiliation(s)
| | - Henk Roose
- Department of Sociology, Ghent University (UGent), Ghent, Belgium
| | | | - Stefaan De Henauw
- Department of Public Health and Primary Care, Ghent University (UGent), Ghent, Belgium
| | - Nathalie Michels
- Department of Developmental, Personality and Social Psychology, Ghent University (UGent), Ghent, Belgium
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13
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Lai KY, Kumari S, Gallacher J, Webster CJ, Sarkar C. Association between Residential Greenness and Allostatic Load: A Cohort Study. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2024; 58:4884-4893. [PMID: 38437596 DOI: 10.1021/acs.est.3c04792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
The association between residential greenness and allostatic load (AL), a marker of composite physiological burden and predictor of chronic disease, remains understudied. This study comprised 212,600 UK Biobank participants recruited over 2007 and 2010 at the baseline. Residential greenness was modeled as the normalized difference vegetation index (NDVI) from high spatial resolution (0.50 m) color infrared imagery and measured within a 0.5 km radial catchment. AL was measured as a composite index from 13 biomarkers comprising three physiological systems (metabolic, cardiovascular, and inflammatory systems) and two organ systems (liver and kidney). Multilevel mixed-effects generalized linear models with a random intercept for UK Biobank assessment centers were employed to examine the association between residential greenness and AL. Each interquartile range (IQR = 0.24) increment in NDVI greenness was associated with lower AL (beta (β) = -0.28, 95% confidence interval (CI) = -0.55, -0.01). Consistently, relative to the lowest NDVI greenness quintile, participants in the highest quintile had lower AL (β = -0.64, 95% CI = -1.02, -0.26). The proportion of the association between greenness and AL mediated by the physical activity was 3.2%. In conclusion, residential greenness was protectively associated with AL, a composite marker of wear and tear and general health.
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Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- Department of Urban Planning & Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Sarika Kumari
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
| | - Christopher John Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- Department of Urban Planning & Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- Urban Systems Institute, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- Department of Urban Planning & Design, Faculty of Architecture, The University of Hong Kong, Pokfulam, Hong Kong Special Administrative Region, China
- Department of Psychiatry, University of Oxford, Oxford OX3 7JX, United Kingdom
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14
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Luque-García L, Muxika-Legorburu J, Mendia-Berasategui O, Lertxundi A, García-Baquero G, Ibarluzea J. Green and blue space exposure and non-communicable disease related hospitalizations: A systematic review. ENVIRONMENTAL RESEARCH 2024; 245:118059. [PMID: 38157973 DOI: 10.1016/j.envres.2023.118059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/05/2023] [Accepted: 12/26/2023] [Indexed: 01/03/2024]
Abstract
The global increase in non-communicable diseases (NCDs) presents a critical public health concern. Emerging evidence suggests that exposure to natural environments may reduce the risk of developing NCDs through multiple pathways. The present systematic review aims to synthesize and evaluate the observational evidence regarding associations between exposure to green and blue spaces and hospital admissions related to NCDs. A comprehensive literature search strategy was conducted in Embase (Ovid), PubMed, and Web of Science. The risk of bias and quality of the evidence were assessed using The Navigation Guide methodology, an approach specifically designed for environmental health research. Of 3060 search results, 17 articles were included. Notably, the majority of the studies (n = 14; 82.4%) were published from 2020 onwards. Most studies were conducted in the United States (n = 6; 35.3%) and China (n = 4; 23.5%). Exposure to green spaces was assessed through all studies, while only three included blue spaces. In terms of study design, cohort design was employed in nearly half of the studies (n = 8; 47.1%), followed by case-crossover design (n = 3, 17.6%). Over 75% of the included studies (n = 13) had a high or probably high rating in the risk of bias assessment. The studies encompassed diverse NCD outcome domains; cardiovascular diseases (CVDs) (n = 10), respiratory diseases (RSDs) (n = 2), heat-related diseases (n = 1), metabolic diseases (n = 2), cancer (n = 1), neurodegenerative diseases (NDDs) (n = 2), and mental health disorders (n = 2). The present review suggests that a clear link between blue space exposure and NCD hospital admissions is not evident. However, exposure to green spaces appears to predominantly have a protective effect, although the direction of the association varies across different outcome domains. The heterogeneity among the outcome domains together with the limited number of studies, emphasizes the need for more robust evidence.
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Affiliation(s)
- L Luque-García
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain.
| | - J Muxika-Legorburu
- Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain
| | - O Mendia-Berasategui
- Osakidetza Basque Health Service, Goierri Alto-Urola Integrated Health Organisation, Zumarraga Hospital, Zumarraga, 20700, Spain
| | - A Lertxundi
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of the Basque Country (UPV/EHU), Leioa, 48940, Spain; Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain
| | - G García-Baquero
- Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Faculty of Biology, University of Salamanca, Avda Licenciado Méndez Nieto S/n, 37007, Salamanca, Spain
| | - J Ibarluzea
- Biogipuzkoa Health Research Institute, Group of Environmental Epidemiology and Child Development, Paseo Doctor Begiristain S/n, 20014, Donostia- San Sebastián, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029, Madrid, Spain; Ministry of Health of the Basque Government, Sub-Directorate for Public Health and Addictions of Gipuzkoa, 20013, San Sebastián, Spain; Faculty of Psychology of the University of the Basque Country, 20018, San Sebastian, Spain
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15
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Patwary MM, Bardhan M, Browning MHEM, Astell-Burt T, van den Bosch M, Dong J, Dzhambov AM, Dadvand P, Fasolino T, Markevych I, McAnirlin O, Nieuwenhuijsen MJ, White MP, Van Den Eeden SK. The economics of nature's healing touch: A systematic review and conceptual framework of green space, pharmaceutical prescriptions, and healthcare expenditure associations. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 914:169635. [PMID: 38159779 DOI: 10.1016/j.scitotenv.2023.169635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
Green spaces play a crucial role in promoting sustainable and healthy lives. Recent evidence shows that green space also may reduce the need for healthcare, prescription medications, and associated costs. This systematic review provides the first comprehensive assessment of the available literature examining green space exposure and its associations with healthcare prescriptions and expenditures. We applied Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines to search MEDLINE, Scopus, and Web of Science for observational studies published in English through May 6, 2023. A quality assessment of the included studies was conducted using the Office of Health Assessment and Translation (OHAT) tool, and the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) assessment was used to evaluate the overall quality of evidence. Our search retrieved 26 studies that met the inclusion criteria and were included in our review. Among these, 20 studies (77 % of the total) showed beneficial associations of green space exposure with healthcare prescriptions or expenditures. However, most studies had risks of bias, and the overall strength of evidence for both outcomes was limited. Based on our findings and related bodies of literature, we present a conceptual framework to explain the possible associations and complex mechanisms underlying green space and healthcare outcomes. The framework differs from existing green space and health models by including upstream factors related to healthcare access (i.e., rurality and socioeconomic status), which may flip the direction of associations. Additional research with lower risks of bias is necessary to validate this framework and better understand the potential for green space to reduce healthcare prescriptions and expenditures.
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Affiliation(s)
- Muhammad Mainuddin Patwary
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Environmental Science Discipline, Life Science School, Khulna University, Khulna, Bangladesh.
| | - Mondira Bardhan
- Environment and Sustainability Research Initiative, Khulna, Bangladesh; Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Matthew H E M Browning
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA.
| | - Thomas Astell-Burt
- School of Architecture, Design, and Planning, University of Sydney, Australia
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; European Forest Institute, Biocities Facility, Rome, Italy; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jiaying Dong
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA; School of Architecture, Clemson University, Clemson, SC, USA
| | - Angel M Dzhambov
- Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Highway Engineering and Transport Planning, Graz University of Technology, Graz, Austria
| | - Payam Dadvand
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Iana Markevych
- Research Group "Health and Quality of Life in a Green and Sustainable Environment", Strategic Research and Innovation Program for the Development of MU - Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria; Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Olivia McAnirlin
- Department of Park, Recreation and Tourism Management, Clemson University, Clemson, SC, USA
| | - Mark J Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Mathew P White
- Cognitive Science Hub, University of Vienna, Vienna, Austria
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16
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Zhang Y, Wu T, Yu H, Fu J, Xu J, Liu L, Tang C, Li Z. Green spaces exposure and the risk of common psychiatric disorders: A meta-analysis. SSM Popul Health 2024; 25:101630. [PMID: 38405164 PMCID: PMC10885792 DOI: 10.1016/j.ssmph.2024.101630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 02/27/2024] Open
Abstract
Objective To explore the effects of green spaces exposure on common psychiatric disorders. Methods PubMed, Embase, Web of Science and MEDLINE were screened and articles published prior to November 15, 2023 were included. Analyses were performed on common psychiatric disorders, categorized into depression, anxiety, dementia, schizophrenia, and attention deficit hyperactivity disorder (ADHD). And the subgroup analyses were conducted for depression, anxiety, dementia, and schizophrenia. Results In total, 2,0064 studies were retrieved, 59 of which were included in our study; 37 for depression, 14 for anxiety, 8 for dementia, 7 for schizophrenia and 5 for ADHD. Green spaces were found to benefit the moderation of psychiatric disorders (OR = 0.91, 95% CI: 0.89 to 0.92). Green spaces positively influence depression (OR = 0.89, 95% CI: 0.86 to 0.93), regardless of the cross-sectional or cohort studies. Green spaces can also help mitigate the risk of anxiety (OR = 0.94, 95%CI:0.92 to 0.96). As an important index for measuring green spaces, a higher normalized difference vegetation index (NDVI) level related to a lower level of depression (OR = 0.95, 95%CI:0.91 to 0.98) and anxiety (OR = 0.95, 95%:0.92 to 0.98). The protection was also found in dementia (OR = 0.95, 95% CI: 0.93 to 0.96), schizophrenia (OR = 0.74, 95% CI: 0.67 to 0.82), and ADHD (OR = 0.89, 95% CI: 0.86 to 0.92) results. Conclusion Green spaces decrease the risk of psychiatric disorders, including depression, anxiety, dementia, schizophrenia, and ADHD. Further studies on green spaces and psychiatric disorders are needed, and more green spaces should be considered in city planning.
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Affiliation(s)
- Yimin Zhang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Tongyan Wu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Hao Yu
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, The Second Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Jianfei Fu
- Department of Medical Records and Statistics, Ningbo First Hospital, Ningbo, China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Chunlan Tang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Zhen Li
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
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17
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Mizen A, Thompson DA, Watkins A, Akbari A, Garrett JK, Geary R, Lovell R, Lyons RA, Nieuwenhuijsen M, Parker SC, Rowney FM, Song J, Stratton G, Wheeler BW, White J, White MP, Williams S, Rodgers SE, Fry R. The use of Enhanced Vegetation Index for assessing access to different types of green space in epidemiological studies. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2024:10.1038/s41370-024-00650-5. [PMID: 38424359 DOI: 10.1038/s41370-024-00650-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Exposure to green space can protect against poor health through a variety of mechanisms. However, there is heterogeneity in methodological approaches to exposure assessments which makes creating effective policy recommendations challenging. OBJECTIVE Critically evaluate the use of a satellite-derived exposure metric, the Enhanced Vegetation Index (EVI), for assessing access to different types of green space in epidemiological studies. METHODS We used Landsat 5-8 (30 m resolution) to calculate average EVI for a 300 m radius surrounding 1.4 million households in Wales, UK for 2018. We calculated two additional measures using topographic vector data to represent access to green spaces within 300 m of household locations. The two topographic vector-based measures were total green space area stratified by type and average private garden size. We used linear regression models to test whether EVI could discriminate between publicly accessible and private green space and Pearson correlation to test associations between EVI and green space types. RESULTS Mean EVI for a 300 m radius surrounding households in Wales was 0.28 (IQR = 0.12). Total green space area and average private garden size were significantly positively associated with corresponding EVI measures (β = < 0.0001, 95% CI: 0.0000, 0.0000; β = 0.0001, 95% CI: 0.0001, 0.0001 respectively). In urban areas, as average garden size increases by 1 m2, EVI increases by 0.0002. Therefore, in urban areas, to see a 0.1 unit increase in EVI index score, garden size would need to increase by 500 m2. The very small β values represent no 'measurable real-world' associations. When stratified by type, we observed no strong associations between greenspace and EVI. IMPACT It is a widely implemented assumption in epidiological studies that an increase in EVI is equivalent to an increase in greenness and/or green space. We used linear regression models to test associations between EVI and potential sources of green reflectance at a neighbourhood level using satellite imagery from 2018. We compared EVI measures with a 'gold standard' vector-based dataset that defines publicly accessible and private green spaces. We found that EVI should be interpreted with care as a greater EVI score does not necessarily mean greater access to publicly available green spaces in the hyperlocal environment.
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Affiliation(s)
- Amy Mizen
- Swansea University Medical School, Swansea University, Swansea, UK.
| | | | - Alan Watkins
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Ashley Akbari
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Rebecca Geary
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - Ronan A Lyons
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Sarah C Parker
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Francis M Rowney
- School of Geography, Earth and Environmental Sciences, University of Plymouth, Plymouth, UK
| | | | - Gareth Stratton
- ASTEM Research Centre, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
| | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, University of Exeter, Truro, UK
- Cognitive Science Hub, University of Vienna, Vienna, Austria
| | | | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Richard Fry
- Swansea University Medical School, Swansea University, Swansea, UK
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18
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Bratman GN, Mehta A, Olvera-Alvarez H, Spink KM, Levy C, White MP, Kubzansky LD, Gross JJ. Associations of nature contact with emotional ill-being and well-being: the role of emotion regulation. Cogn Emot 2024:1-20. [PMID: 38362747 DOI: 10.1080/02699931.2024.2316199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 02/03/2024] [Indexed: 02/17/2024]
Abstract
Nature contact has associations with emotional ill-being and well-being. However, the mechanisms underlying these associations are not fully understood. We hypothesised that increased adaptive and decreased maladaptive emotion regulation strategies would be a pathway linking nature contact to ill-being and well-being. Using data from a survey of 600 U.S.-based adults administered online in 2022, we conducted structural equation modelling to test our hypotheses. We found that (1) frequency of nature contact was significantly associated with lesser emotional ill-being and greater emotional well-being, (2) effective emotion regulation was significantly associated with lesser emotional ill-being and greater emotional well-being, and (3) the associations of higher frequency of nature contact with these benefits were partly explained via emotion regulation. Moreover, we found a nonlinear relationship for the associations of duration of nature contact with some outcomes, with a rise in benefits up to certain amounts of time, and a levelling off after these points. These findings support and extend previous work that demonstrates that the associations of nature contact with emotional ill-being and well-being may be partly explained by changes in emotion regulation.
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Affiliation(s)
- Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, USA
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Ashish Mehta
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | | | - Chaja Levy
- School of Environmental and Forest Sciences, University of Washington, Seattle, WA, USA
| | - Mathew P White
- Cognitive Science Hub, University of Vienna, Wien, Austria
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - James J Gross
- Department of Psychology, Stanford University, Stanford, CA, USA
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19
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Fossa AJ, D'Souza J, Bergmans R, Zivin K, Adar SD. Residential greenspace and major depression among older adults living in urban and suburban areas with different climates across the United States. ENVIRONMENTAL RESEARCH 2024; 243:117844. [PMID: 38061587 DOI: 10.1016/j.envres.2023.117844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 11/04/2023] [Accepted: 11/30/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND AND AIM Residential greenspace could alleviate depression - a leading cause of disability. Fewer studies of depression and greenspace have considered major depression, and, to our knowledge, none have considered how climate, which determines vegetation abundance and type, may change the impacts of greenspace. Our aim was to investigate whether residential greenspace is associated with major depression among older adults and explore effect modification by climate. METHODS We used biennial interviews between 2008 and 2016 from the Health and Retirement Study. We calculated greenness within walking distance of home addresses as the maximum NDVI for the year of each participant interview averaged within a 1 km buffer. Reflecting clinical criteria, a score of ≥5 on the CIDI-SF indicated major depression in the preceding 12-months. We characterized climate using Köppen-Geiger classifications. To estimate prevalence ratios, we used Poisson regression. Our models adjusted for sociodemographic characteristics, geography, annual sunshine, and bluespace. RESULTS The 21,611 eligible participants were 65 ± 10 years old on average, 55% female, 81% White, 12% Black, 10% Hispanic/Latino, and 31% had at least a 4-year college degree. The 12-month prevalence of a major depression was 8%. In adjusted models, more residential greenspace was associated with a lower prevalence of major depression (prevalence ratio per IQR, 0.91; 95% CI, 0.84 to 0.98). There was evidence of effect modification by climate (P forinteraction, 0.062). We observed stronger associations in tropical (prevalence ratio per IQR 0.69; 95% CI, 0.47 to 1.01) and cold (prevalence ratio per IQR, 0.83; 95% CI, 0.74 to 0.93) climates compared to arid (prevalence ratio per IQR 0.99; 95% CI, 0.90 to 1.09) and temperate (prevalence ratio per IQR 0.98; 95% CI, 0.86 to 1.11) climates. CONCLUSIONS Residential greenspace may help reduce major depression. However, climate may influence how people benefit from greenspace.
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Affiliation(s)
- Alan J Fossa
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, United States.
| | - Jennifer D'Souza
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, United States
| | - Rachel Bergmans
- University of Michigan, Medical School, Department of Anesthesiology, Ann Arbor, MI, United States
| | - Kara Zivin
- University of Michigan Medical School, Department of Psychiatry, Ann Arbor, MI, United States; VA Ann Arbor Healthcare System, Center for Clinical Management Research, Ann Arbor, MI, United States
| | - Sara D Adar
- University of Michigan School of Public Health, Department of Epidemiology, Ann Arbor, MI, United States
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20
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Wu W, Wu G, Wei J, Lawrence WR, Deng X, Zhang Y, Chen S, Wang Y, Lin X, Chen D, Ruan X, Lin Q, Li Z, Lin Z, Hao C, Du Z, Zhang W, Hao Y. Potential causal links and mediation pathway between urban greenness and lung cancer mortality: Result from a large cohort (2009 to 2020). SUSTAINABLE CITIES AND SOCIETY 2024; 101:105079. [PMID: 38222851 PMCID: PMC10783447 DOI: 10.1016/j.scs.2023.105079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
Urban greenness, as a vital component of the urban environment, plays a critical role in mitigating the adverse effects of rapid urbanization and supporting urban sustainability. However, the causal links between urban greenness and lung cancer mortality and its potential causal pathway remain poorly understood. Based on a prospective community-based cohort with 581,785 adult participants in southern China, we applied a doubly robust Cox proportional hazard model to estimate the causal associations between urban greenness exposure and lung cancer mortality. A general multiple mediation analysis method was utilized to further assess the potential mediating roles of various factors including particulate matter (PM1, PM2.5-1, and PM10-2.5), temperature, physical activity, and body mass index (BMI). We observed that each interquartile range (IQR: 0.06) increment in greenness exposure was inversely associated with lung cancer mortality, with a hazard ratio (HR) of 0.89 (95 % CI: 0.83, 0.96). The relationship between greenness and lung cancer mortality might be partially mediated by particulate matter, temperature, and physical activity, yielding a total indirect effect of 0.826 (95 % CI: 0.769, 0.887) for each IQR increase in greenness exposure. Notably, the protective effect of greenness against lung cancer mortality could be achieved primarily by reducing the particulate matter concentration.
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Affiliation(s)
- Wenjing Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Gonghua Wu
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, USA
| | - Wayne R Lawrence
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Xinlei Deng
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Durham, USA
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Shirui Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Ying Wang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Dan Chen
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Xinling Ruan
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Qiaoxuan Lin
- Department of Statistics, Guangzhou Health Technology Identification & Human Resources Assessment Center, China
| | - Zhiqiang Li
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Ziqiang Lin
- Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, China
| | - Chun Hao
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Zhicheng Du
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health & Center for Health Information Research &Sun Yat-sen Global Health Institute, Sun Yat-sen University, Guangzhou, China
| | - Yuantao Hao
- Peking University Center for Public Health and Epidemic Preparedness & Response, Peking, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Ministry of Education, China
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21
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Trammell JP, Harriger JA, Krumrei-Mancuso EJ. Walking in nature may improve affect but not cognition. Front Psychol 2024; 14:1258378. [PMID: 38250104 PMCID: PMC10797046 DOI: 10.3389/fpsyg.2023.1258378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024] Open
Abstract
Beneficial effects of natural environments on affect have been consistently reported, but effects on cognition have been less consistent. We examined affect and cognitive performance in the domains of attention, working memory, executive function, and recall and recognition memory in a sample of 188 undergraduate participants who completed a walk in one of three environments: an outdoor nature environment, an outdoor urban environment, or an indoor (treadmill) environment. Supporting the hypotheses, the outdoor nature environment resulted in the greatest increase in positive affect and decrease in negative affect from pre-to post-walk. However, there were no effects of location on any cognitive measure. These results suggest that cognitive effects do not always occur in tandem with affective benefits. Possible explanations, including prior frequent exposure to nature in our participants and extremity of the natural environment, are discussed.
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22
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Fian L, White MP, Arnberger A, Thaler T, Heske A, Pahl S. Nature visits, but not residential greenness, are associated with reduced income-related inequalities in subjective well-being. Health Place 2024; 85:103175. [PMID: 38266374 DOI: 10.1016/j.healthplace.2024.103175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 12/04/2023] [Accepted: 01/10/2024] [Indexed: 01/26/2024]
Abstract
Nature exposure can promote human health and well-being. Additionally, there is some, albeit mixed, evidence that this relationship is stronger for socio-economically disadvantaged groups (equigenesis). Using a cross-sectional survey of the Austrian population (N = 2300), we explored the relationships between both residential greenness and recreational nature visits, and affective (WHO-5 Well-Being Index) and evaluative (Personal Well-Being Index-7) subjective well-being. Partially supporting the equigenesis hypothesis, regression analyses controlling for potential confounders found that recreational visit frequency, but not residential greenness, moderated the effect of income-related disparities in both subjective well-being metrics. Results suggest that merely making neighborhoods greener may not itself help reduce inequalities in subjective well-being. Additionally, greater efforts are also needed to support individuals from all sectors of society to access natural settings for recreation as this could significantly improve the well-being of some of the poorest in society.
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Affiliation(s)
- Leonie Fian
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria.
| | - Mathew P White
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria; Cognitive Science HUB, University of Vienna, Vienna, Austria; Environment and Climate Research HUB, University of Vienna, Vienna, Austria
| | - Arne Arnberger
- Institute of Landscape Development, Recreation and Conservation Planning, University of Natural Resources and Life Sciences, Vienna, Austria
| | - Thomas Thaler
- Institute of Landscape Planning (ILAP), University of Natural Resources and Life Sciences, Vienna, Austria
| | - Anja Heske
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
| | - Sabine Pahl
- Urban and Environmental Psychology Group, Department of Cognition, Emotion, and Methods in Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria; Environment and Climate Research HUB, University of Vienna, Vienna, Austria
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23
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Vegaraju A, Amiri S. Urban green and blue spaces and general and mental health among older adults in Washington state: Analysis of BRFSS data between 2011-2019. Health Place 2024; 85:103148. [PMID: 38043153 DOI: 10.1016/j.healthplace.2023.103148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/05/2023]
Abstract
A growing body of evidence highlights the significant effect of built environment features on mental and general health. This study examined the association between distance to and percentage of green and blue space measures and serious psychological distress, general health, and frequent mental distress among older adults living in urban ZIP codes in Washington state. Percentage of green space, particularly tree canopy and forest space, was significantly associated with better self-rated general health and reduced odds of serious psychological distress. Closer distance to blue space was associated with better self-rated general health. Programs which incentivize exposure to green and blue spaces for urban-dwelling, older adults may improve health outcomes.
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Affiliation(s)
- Adithya Vegaraju
- Elson S. Floyd College of Medicine, Washington State University, USA.
| | - Solmaz Amiri
- Elson S. Floyd College of Medicine, Washington State University, USA; Institute for Research and Education to Advance Community Health, USA
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24
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Brambilla E, Petersen E, Stendal K, Sundling V, MacIntyre TE, Calogiuri G. Effects of immersive virtual nature on nature connectedness: A systematic review and meta-analysis. Digit Health 2024; 10:20552076241234639. [PMID: 38533309 PMCID: PMC10964443 DOI: 10.1177/20552076241234639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 01/26/2024] [Indexed: 03/28/2024] Open
Abstract
Objective This study systematically summarizes the extant literature on the impacts of immersive virtual nature (IVN) on nature connectedness in the general population. Methods Papers were considered eligible if peer-reviewed, in English language, comprising experimental or quasi-experimental trials, including at least one outcome relative to nature connectedness in the general population. Database search was conducted on Scopus, Web of Science, Google Scholar, Medline, and GreenFILE (22-28 November 2021). Risk of bias was established by the Cochrane RoB 2 tool. Data synthesis was conducted through meta-analysis according with the Cochrane Consumers and Communication Group guidelines. Results Six eligible papers (9 studies; n = 730) were selected, in which IVN was compared to (i) non-immersive virtual nature, (ii) immersive virtual built environments, (iii) non-immersive virtual built environments, and (iv) actual nature. The risk of bias was predominantly "low" or of "some concerns." Meta-analyses showed a statistically significant overall effect for the first (g = 0.26; 95% CI = 0.06-0.45; I2 = 35%) and fourth group (g = -1.98; 95% CI = -3.21 to -0.75; I2 = 96%), the former in favor of IVN and the latter in favor of actual nature. Subgroup analyses were conducted for the first and second groups of studies to explore possible sources of heterogeneity. The small number of studies available limits the validity of the outcomes of the meta-analyses. Conclusion The findings indicate that IVN may be an effective tool for the promotion of nature connectedness, although the evidence in this field is still limited and largely mixed. Recommendations for future research are discussed.
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Affiliation(s)
- Elena Brambilla
- Centre for Health and Technology, Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Evi Petersen
- Department of Sports, Physical Education and Outdoor Studies, University of South-Eastern Norway, Bø, Norway
- Department of Early Childhood Education, Oslo Metropolitan University, Oslo, Norway
| | - Karen Stendal
- Department of Business, Marketing and Law, University of South-Eastern Norway, Ringerike, Norway
| | - Vibeke Sundling
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Tadhg E MacIntyre
- All Institute, Department of Psychology, Maynooth University, Maynooth, Irlanda
| | - Giovanna Calogiuri
- Centre for Health and Technology, Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway
- Section for Public Health, Department of Public Health and Sport Sciences, Inland Norway University of Applied Science, Elverum, Norway
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25
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LeFevre GH, Hendricks MD, Carrasquillo ME, McPhillips LE, Winfrey BK, Mihelcic JR. The Greatest Opportunity for Green Stormwater Infrastructure Is to Advance Environmental Justice. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:19088-19093. [PMID: 37978915 DOI: 10.1021/acs.est.3c07062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Affiliation(s)
- Gregory H LeFevre
- Department of Civil and Environmental Engineering and IIHR─Hydroscience & Engineering, University of Iowa, Iowa City, Iowa 52242, United States
| | - Marccus D Hendricks
- School of Architecture, Planning & Preservation, University of Maryland, College Park, Maryland 20742, United States
| | - Maya E Carrasquillo
- Department of Civil & Environmental Engineering, University of California─Berkeley, Berkeley, California 94720, United States
| | - Lauren E McPhillips
- Department of Civil and Environmental Engineering and Department of Agricultural and Biological Engineering, The Pennsylvania State University, University Park, Pennsylvania 16802, United States
| | - Brandon K Winfrey
- Department of Civil Engineering, Monash University, Clayton, Victoria 3800, Australia
| | - James R Mihelcic
- Department of Civil & Environmental Engineering, University of South Florida, Tampa, Florida 33620, United States
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26
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Liu Y, Kwan MP, Wong MS, Yu C. Current methods for evaluating people's exposure to green space: A scoping review. Soc Sci Med 2023; 338:116303. [PMID: 37866172 DOI: 10.1016/j.socscimed.2023.116303] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/09/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023]
Abstract
People's exposure to green space is a critical link between urban green space and urban residents' health. Since green space may affect human health through multiple pathways regarding diverse human health outcomes, the measurement of people's exposure to green space must be tailored to concrete study contexts and research questions. In this scoping review, we systematically categorized the available green space representations and metrics in the last two decades that can be used to derive people's exposure to green space regarding different research topics. A three-phase systematic review was conducted after a generalized search of relevant research articles from the three most-used publication databases, namely Scopus, the Web of Science, and PubMed. We identified 260 research articles that particularly discuss green space representations and metrics. We further developed a multi-pathway framework to articulate the complicated context issues in green space studies. We categorized the most relevant green space representations and metrics into five groups, including green space indices, the delineation, inventory, and usage of green space, the spatiotemporal evolution of green space, the attributes and components of green space, and the green space landscape and fragmentation. Finally, we discussed the inter-conversion between different green space representations and metrics, the "mobility-turn" in green space studies and how it may affect the derivation of people's exposure to green space, and other potential methodological issues in measuring people's exposure to green space. Our scoping review provides the most comprehensive framework and categories for deriving people's exposure to green space to date, which may strongly support a broad range of studies that concern green space's health effects.
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Affiliation(s)
- Yang Liu
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Mei-Po Kwan
- Department of Geography and Resource Management, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong SAR, China; Institute of Future Cities, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Man Sing Wong
- Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong SAR, China; Research Institute for Land and Space, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Changda Yu
- Institute of Space and Earth Information Science, The Chinese University of Hong Kong, Hong Kong SAR, China
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27
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Wilt GE, Roscoe CJ, Hu CR, Mehta UV, Coull BA, Hart JE, Gortmaker S, Laden F, James P. Minute level smartphone derived exposure to greenness and consumer wearable derived physical activity in a cohort of US women. ENVIRONMENTAL RESEARCH 2023; 237:116864. [PMID: 37648192 PMCID: PMC11146007 DOI: 10.1016/j.envres.2023.116864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/31/2023] [Accepted: 08/08/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND Inconsistent results have been found in the literature on associations of greenness, or vegetation quantity, and physical activity. However, few studies have assessed associations between mobility-based greenness and physical activity from mobile health data from smartphone and wearable devices with fine spatial and temporal resolution. METHODS We assessed mobility-based greenness exposure and wearable accelerometer data from participants in the US-based prospective Nurses' Health Study 3 cohort Mobile Health (mHealth) Substudy (2018-2020). We recruited 500 female participants with instructions to wear devices over four 7-day sampling periods equally spaced throughout the year. After restriction criteria there were 337 participants (mean age 36 years) with n = 639,364 unique observations. Normalized Difference Vegetation Index (NDVI) data were derived from 30 m x 30 m Landsat-8 imagery and spatially joined to GPS points recorded every 10 min. Fitbit proprietary algorithms provided physical activity summarized as mean number of steps per minute, which we averaged during the 10-min period following a GPS-based greenness exposure assessment. We utilized Generalized Additive Mixed Models to examine associations (every 10 min) between greenness and physical activity adjusting for neighborhood and individual socioeconomic status, Census region, season, neighborhood walkability, daily mean temperature and precipitation. We assessed effect modification through stratification and interaction models and conducted sensitivity analyses. RESULTS Mean 10-min step count averaged 7.0 steps (SD 14.9) and greenness (NDVI) averaged 0.3 (SD 0.2). Contrary to our hypotheses, higher greenness exposure was associated non-linearly with lower mean steps per minute after adjusting for confounders. We observed statistically significant effect modification by Census region and season. DISCUSSION We utilized objective physical activity data at fine temporal and spatial scales to present novel estimates of the association between mobility-based greenness and step count. We found higher levels of greenness were inversely associated with steps per minute.
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Affiliation(s)
- Grete E Wilt
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States.
| | - Charlotte J Roscoe
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States; Division of Population Sciences, Dana Farber Cancer Institute, Boston, MA, United States
| | - Cindy R Hu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Unnati V Mehta
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Brent A Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Jaime E Hart
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Steven Gortmaker
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Francine Laden
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Peter James
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States; Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
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28
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White MP, Hartig T, Martin L, Pahl S, van den Berg AE, Wells NM, Costongs C, Dzhambov AM, Elliott LR, Godfrey A, Hartl A, Konijnendijk C, Litt JS, Lovell R, Lymeus F, O'Driscoll C, Pichler C, Pouso S, Razani N, Secco L, Steininger MO, Stigsdotter UK, Uyarra M, van den Bosch M. Nature-based biopsychosocial resilience: An integrative theoretical framework for research on nature and health. ENVIRONMENT INTERNATIONAL 2023; 181:108234. [PMID: 37832260 DOI: 10.1016/j.envint.2023.108234] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 09/09/2023] [Accepted: 09/25/2023] [Indexed: 10/15/2023]
Abstract
Nature-based solutions including urban forests and wetlands can help communities cope better with climate change and other environmental stressors by enhancing social-ecological resilience. Natural ecosystems, settings, elements and affordances can also help individuals become more personally resilient to a variety of stressors, although the mechanisms underpinning individual-level nature-based resilience, and their relations to social-ecological resilience, are not well articulated. We propose 'nature-based biopsychosocial resilience theory' (NBRT) to address these gaps. Our framework begins by suggesting that individual-level resilience can refer to both: a) a person's set of adaptive resources; and b) the processes by which these resources are deployed. Drawing on existing nature-health perspectives, we argue that nature contact can support individuals build and maintain biological, psychological, and social (i.e. biopsychosocial) resilience-related resources. Together with nature-based social-ecological resilience, these biopsychosocial resilience resources can: i) reduce the risk of various stressors (preventive resilience); ii) enhance adaptive reactions to stressful circumstances (response resilience), and/or iii) facilitate more rapid and/or complete recovery from stress (recovery resilience). Reference to these three resilience processes supports integration across more familiar pathways involving harm reduction, capacity building, and restoration. Evidence in support of the theory, potential interventions to promote nature-based biopsychosocial resilience, and issues that require further consideration are discussed.
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Affiliation(s)
- Mathew P White
- Cognitive Science HUB, University of Vienna, Austria; European Centre for Environment & Human Health, University of Exeter, UK.
| | - Terry Hartig
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | - Leanne Martin
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Sabine Pahl
- Urban and Environmental Psychology Group, University of Vienna, Austria
| | | | - Nancy M Wells
- Department of Human Centered Design, College of Human Ecology, Cornell University, Ithaca, NY, United States
| | | | - Angel M Dzhambov
- Department of Hygiene, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria; Environmental Health Division, Research Institute at Medical University of Plovdiv, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Lewis R Elliott
- European Centre for Environment & Human Health, University of Exeter, UK
| | | | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Jill S Litt
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rebecca Lovell
- European Centre for Environment & Human Health, University of Exeter, UK
| | - Freddie Lymeus
- Institute for Housing and Urban Research, Uppsala University, Sweden; Department of Psychology, Uppsala University, Sweden
| | | | - Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | - Sarai Pouso
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Nooshin Razani
- University of California San Francisco, San Francisco, CA, United States
| | - Laura Secco
- Department of Territorio e Sistemi Agro-Forestali (TESAF), University of Padua, Padua, Italy
| | | | - Ulrika K Stigsdotter
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Denmark
| | - Maria Uyarra
- AZTI, Marine Research, Basque Research and Technology Alliance (BRTA), Herrera Kaia, Portualdea z/g, 20110 Pasaia, Gipuzkoa, Spain
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra, Barcelona, Spain; Ciber on Epidemiology and Public Health (CIBERESP), Madrid, Spain
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29
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Humbert A, Kohls E, Baldofski S, Epple C, Rummel-Kluge C. Acceptability, feasibility, and user satisfaction of a virtual reality relaxation intervention in a psychiatric outpatient setting during the COVID-19 pandemic. Front Psychiatry 2023; 14:1271702. [PMID: 37953932 PMCID: PMC10634536 DOI: 10.3389/fpsyt.2023.1271702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 10/12/2023] [Indexed: 11/14/2023] Open
Abstract
Background The COVID-19 pandemic was particularly difficult for individuals with mental disorders. Due to governmental restrictions, face-to-face offers for psychiatric outpatients like therapies, psychoeducational groups or relaxation courses were limited. Virtual reality (VR) might be a new possibility to support these patients by providing them with a home-based relaxation tool. Objective The aim of this study was to evaluate the acceptability, feasibility, and user satisfaction of a supportive therapy-accompanying, relaxation VR intervention in psychiatric outpatients during the COVID-19 pandemic in Germany. Methods The four-weeks VR intervention consisted of regular watching of relaxing videos in the participants' home environment. Sociodemographics, feasibility (frequency of use, user-friendliness), satisfaction (Client Satisfaction Questionnaire-8), depressive symptoms (Patient Health Questionnaire-9), quality of life (abbreviated World Health Organization Quality of Life assessment), and credibility and expectancy (Credibility Expectancy Questionnaire-8) were measured in an intention-to-treat (ITT) analysis and a per-protocol (PP) analysis of completers. Results In total, N = 40 patients participated in the study. Most of the participants in the ITT analysis (n = 30, 75.0%) used the VR device three or 4 weeks. A majority of the N = 29 completers (PP: n = 18, 62.1%) used it all 4 weeks. Most participants used the device two or more times a week (ITT: n = 30, 83.3%; PP: n = 26, 89.7%) and described the user-friendliness as rather or very easy (ITT: n = 33, 91.7%; PP: n = 26, 89.7%). User satisfaction was high (ITT: 19.42, SD = 4.08; PP: M = 20.00, SD = 4.19) and did not correlate with participants' sex or age (all p < 0.05). Depressive symptoms and psychological quality of life improved significantly from pre-to post-intervention (ITT and PP, all p < 0.05). Higher pre-intervention credibility significantly correlated with a better outcome of satisfaction (ITT and PP), depressive symptoms, physical, psychological, and social quality of life (PP; all p < 0.05). Conclusion A supportive therapy-accompanying VR relaxation intervention is feasible and acceptable in a psychiatric outpatient setting. Due to the high satisfaction and user-friendliness, VR can be an easy to implement relaxation tool to support psychiatric outpatients. Clinical trial registration https://clinicaltrials.gov/, DRKS00027911.
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Affiliation(s)
- Annika Humbert
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | - Elisabeth Kohls
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
| | - Sabrina Baldofski
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
| | | | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, Medical Faculty, Leipzig University, Leipzig, Germany
- Department of Psychiatry and Psychotherapy, Leipzig University Medical Center, Leipzig, Germany
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30
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Borgi M, Collacchi B, Cirulli F, Medda E. Reduction in the use of green spaces during the COVID-19 pandemic and its impact on mental health. Health Place 2023; 83:103093. [PMID: 37527570 DOI: 10.1016/j.healthplace.2023.103093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/31/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023]
Abstract
Our study examined the use of green spaces before and during the pandemic in a large cohort of Italian twins and evaluated its impact on measures of mental health (depressive, anxiety, stress symptoms). Twins were analysed as individuals and as pairs. A twin design approach was applied to minimize confounding by genetic and shared environmental factors. Questionnaires from 2,473 twins enrolled in the Italian Twin Registry were screened. Reduced green space use was associated with significantly higher levels of depression, anxiety and distress. Being a woman, residing in urban areas, and having a high perceived risk of the outbreak resulted in a higher likelihood to modify green space use, with a negative impact on mental health.
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Affiliation(s)
- Marta Borgi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, I-00161, Rome, Italy
| | - Barbara Collacchi
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, I-00161, Rome, Italy
| | - Francesca Cirulli
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, I-00161, Rome, Italy.
| | - Emanuela Medda
- Center for Behavioral Sciences and Mental Health, Istituto Superiore di Sanità, Viale Regina Elena 299, I-00161, Rome, Italy
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31
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Li A, Mansour A, Bentley R. Green and blue spaces, COVID-19 lockdowns, and mental health: An Australian population-based longitudinal analysis. Health Place 2023; 83:103103. [PMID: 37611381 DOI: 10.1016/j.healthplace.2023.103103] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 08/11/2023] [Accepted: 08/14/2023] [Indexed: 08/25/2023]
Abstract
Australia experienced some of the world's longest and most stringent lockdowns during the COVID-19 pandemic. While lockdown measures had consequences for mental health, investigation is lacking on the potential for green and blue space coverage within people's local environments to ameliorate the impact of lockdowns with varied lengths using longitudinal cohorts. This study examined the impact of lockdown durations on population mental health and tests the effect modification of neighbourhood green and inland and coastal blue space coverage in metropolitan areas. We merged population-based longitudinal data on more than 11,000 individuals collected over a ten-year period from 2012 to 2021 with national land use data describing green and blue space coverage. We used fixed effect models to estimate the relationship between lockdowns (with different durations and staggered introduction) and mental health, controlling for sociodemographic, health, and geographical confounders, and tested the significance of effect modification of green and blue space. Results show that extended lockdowns led to considerably larger decreases in mental health (COVID-y1: -2.66, 95%CI: -3.43, -1.89; COVID-y2: -2.65, 95%CI: -3.33, -1.97) relative to short lockdowns. The mental health effect of lockdowns was smaller where green spaces and inland and coastal blue spaces were available. Effect modification was statistically significant for green space, with smaller negative mental health effects observed where there was sizeable green space coverage, particularly during long lockdowns (COVID-y1: -2.69, 95%CI: -3.63, -1.76 for coverage <5%; -3.27, 95%CI: -4.70, -1.84 for coverage 5%-10%; -0.60, 95%CI: -2.03, 0.83 for coverage ≥30%; COVID-y2: -2.74, 95%CI: -3.62, -1.87 for coverage <5%, -2.95, 95%CI: -3.98, -1.92 for coverage 5%-10%; -2.08, 95%CI: -3.28, -0.88 for coverage ≥30%). Findings support the consideration of nature exposure to improve people's mental wellbeing and resilience when designing lockdown measures in response to future public health emergencies.
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Affiliation(s)
- Ang Li
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia.
| | - Adelle Mansour
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia
| | - Rebecca Bentley
- NHMRC Centre of Research Excellence in Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Australia
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Oliver DM, McDougall CW, Robertson T, Grant B, Hanley N, Quilliam RS. Self-reported benefits and risks of open water swimming to health, wellbeing and the environment: Cross-sectional evidence from a survey of Scottish swimmers. PLoS One 2023; 18:e0290834. [PMID: 37639394 PMCID: PMC10461842 DOI: 10.1371/journal.pone.0290834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
Engaging with natural environments benefits human health by providing opportunities for social interactions, enhancing mental wellbeing and enabling outdoor spaces for physical exercise. Open water swimming has seen a rapid increase in popularity, partly due to the physical health benefits it can provide but also with the growing interest in (re)connecting with nature for environment-health interactions. Using a national-scale online survey of 717 open water swimmers, the aim of this study was to investigate patterns and trends in the perceived benefits and risks of open water swimming to both public health and the environment; and to understand whether these perceived risks and benefits vary across different typologies of swimmers and open water, or 'blue space', environments. Strong associations were found between the most important self-reported benefit associated with open water swimming and both participant age and the categorisation of their typical swim style. All but one of the age-groups surveyed perceived mental wellbeing benefits to be the most important benefit of open water swimming; whilst those aged over 65 identified physical rather than mental wellbeing benefits to be the most important outcome. Participants who preferred lake swimming reported greater concern regarding possible environmental damage caused by the increasing popularity of open water swimming compared to those engaging in river or sea swimming. However, the majority of participants perceived the risks to the environment from open water swimming to be minimal. Our study adds to the growing evidence that open water swimming is perceived by participants as benefitting their mental and physical wellbeing. Improved understanding of the benefits and risks of engaging with blue spaces used for open water swimming can contribute to co-designed policy development to promote safer, healthier and more sustainable outdoor recreation opportunities associated with this increasingly popular outdoor pursuit.
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Affiliation(s)
- David M. Oliver
- Biological and Environmental Sciences, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Craig W. McDougall
- Scottish Collaboration for Public Health Research and Policy, School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, United Kingdom
| | - Tony Robertson
- Biological and Environmental Sciences, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Blair Grant
- Biological and Environmental Sciences, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
| | - Nick Hanley
- School of Biodiversity, One Health & Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Richard S. Quilliam
- Biological and Environmental Sciences, Faculty of Natural Sciences, University of Stirling, Stirling, United Kingdom
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Cao S, Shang Z, Li X, Luo H, Sun L, Jiang M, Du J, Fu E, Ma J, Li N, Guo B, Yu X, Lv B, Wang J. Cloudy or sunny? Effects of different environmental types of urban green spaces on public physiological and psychological health under two weather conditions. Front Public Health 2023; 11:1258848. [PMID: 37701912 PMCID: PMC10493420 DOI: 10.3389/fpubh.2023.1258848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023] Open
Abstract
Numerous studies have demonstrated that urban green spaces (UGSs) benefit human health, but few have focused on the influence of weather on environmental restorativeness. This study assessed how different weather conditions and environments affect human health. We exposed 50 participants to different UGS environments under cloudy and sunny conditions and collected physiological, psychological and aesthetic preference data. The result showed that the physical and mental benefits of UGSs were stronger on sunny days (pulse: [t = 2.169, p < 0.05]; positive affect: [Z = -10.299, p < 0.001]; perceived restortiveness: [Z = -3.224, p < 0.01]). The spaces with exposed sky had greater physiological restorativeness on sunny days; the spaces with calm water had greater emotional restorativeness on cloudy days, and natural spaces with less sky exposure had greater perceived restoration in both weather conditions. The spaces with water and less sky exposure promoted psychophysiological restoration in both weather conditions. This study demonstrates that weather significantly influences the restorative potential of UGSs, and there are also restorative variations in different green space environments under two weather conditions. In future UGS planning practices, it would be advisable to select appropriate environmental types and features based on the climatic characteristics of different regions. For instance, in areas with frequent overcast conditions, incorporating serene water bodies could be advantageous, while regions with predominantly sunny weather should encompass spaces with expansive sky views. By conducting comprehensive research on restoration environments that take weather conditions into account, new insights and nature-based solutions can be provided for creating healthy human habitats in the context of global climate change.
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Affiliation(s)
- Saixin Cao
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Zike Shang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Xi Li
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Hao Luo
- Guangdong Academy of Forestry, Guangdong Provincial Key Laboratory of Silviculture Protection and Utilization, Guangzhou, China
| | - Lingxia Sun
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Mingyan Jiang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Juan Du
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Erkang Fu
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Jun Ma
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Nian Li
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Baimeng Guo
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Xiaofang Yu
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Bingyang Lv
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
| | - Jinde Wang
- College of Landscape Architecture, Sichuan Agricultural University, Chengdu, China
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Bandeira M, Graham MA, Ebersöhn L. The significance of feeling safe for resilience of adolescents in sub-Saharan Africa. Front Psychol 2023; 14:1183748. [PMID: 37663363 PMCID: PMC10469746 DOI: 10.3389/fpsyg.2023.1183748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/01/2023] [Indexed: 09/05/2023] Open
Abstract
Introduction Adolescents in sub-Saharan Africa (SSA) are exposed to several challenges and risk factors, linked to historical legacies. Sub-Saharan Africa has one of the highest rates of poverty and inequality in the world, is one of the regions most negatively affected by climate change, performs poorly on many health measures, and has high rates of different forms of violence, especially gender-based violence. These contextual challenges impact adolescent mental health outcomes, preventing them to access resilience-enabling pathways that support positive outcomes despite adversity. This study aimed to contribute to knowledge generation on resilience of young people in the understudied SSA region by investigating which variables directly (or indirectly) affect the resilience of adolescents. Methods Purposive sampling was used to collect quantitative survey data from 3,312 adolescents (females = 1,818; males = 1,494) between the ages of 12 and 20 years, participating in interventions implemented by a non-governmental organization, the Regional Psychosocial Support Initiative. Data were collected in Angola (385, 11.6%), Eswatini (128, 3.9%), Kenya (390, 11.8%), Lesotho (349, 10.5%), Mozambique (478, 14.4%), Namibia (296, 8.9%), South Africa (771, 23.3%), Uganda (201, 6.1%), and Zambia (314, 9.5%). The survey collected data on socio-demographic status, resilience (CYRM-R), depression (PHQ-9), self-esteem (Rosenberg Self-Esteem Scale) and feelings of safety (self-developed scale). Mental health was defined as lower levels of depression, higher levels of self-esteem and higher levels of feeling safe. A mediation analysis was conducted to investigate the relationship between the predictors (the socio-demographic variables) and the output (resilience), with the mediators being depression, self-esteem and feeling safe (which all link to mental health). Results This study contributes to a gap in knowledge on country-level comparative evidence on significant predictors that impact resilience outcomes (directly or indirectly) for adolescents in sub-Saharan African countries. The results indicate that, when considering all countries collectively, feeling safe is the only predictor that has a significant direct effect on overall resilience and personal resilience, but not on caregiver resilience. When considering each country separately, feeling safe has a direct effect on overall, personal and caregiver resilience for all countries; but not for South Africa and Mozambique. Discussion The results provide evidence on which to craft youth development interventions by measuring mediators (depression, self-esteem and feeling safe) and resilience for adolescents in sub-Saharan Africa. The overall results of the present paper point toward a contextually relevant pathway to supporting their resilience, namely, the need to systemically target the creation and/or strengthening of structures that enable adolescents to feel safe.
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Affiliation(s)
- Monica Bandeira
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
| | - Marien A. Graham
- Department of Science, Mathematics and Technology Education, University of Pretoria, Pretoria, South Africa
| | - Liesel Ebersöhn
- Centre for the Study of Resilience and Department of Educational Psychology University of Pretoria, Pretoria, South Africa
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Elliott LR, Pasanen T, White MP, Wheeler BW, Grellier J, Cirach M, Bratman GN, van den Bosch M, Roiko A, Ojala A, Nieuwenhuijsen M, Fleming LE. Nature contact and general health: Testing multiple serial mediation pathways with data from adults in 18 countries. ENVIRONMENT INTERNATIONAL 2023; 178:108077. [PMID: 37413929 DOI: 10.1016/j.envint.2023.108077] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/05/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023]
Abstract
The role of neighbourhood nature in promoting good health is increasingly recognised in policy and practice, but consistent evidence for the underlying mechanisms is lacking. Heterogeneity in exposure methods, outcome measures, and population characteristics, little exploration of recreational use or the role of different types of green or blue space, and multiple separate mediation models in previous studies have limited our ability to synthesise findings and draw clear conclusions. We examined multiple pathways linking different types of neighbourhood nature with general health using a harmonised international sample of adults. Using cross-sectional survey data from 18 countries (n = 15,917), we developed a multigroup path model to test theorised pathways, controlling for sociodemographic variables. We tested the possibility that neighbourhood nature (e.g. greenspace, inland bluespace, and coastal bluespace) would be associated with general health through lower air pollution exposure, greater physical activity attainment, more social contact, and higher subjective well-being. However, our central prediction was that associations between different types of neighbourhood nature and general health would largely be serially mediated by recent visit frequency to corresponding environment types, and, subsequently, physical activity, social contact, and subjective well-being associated with these frequencies. Several subsidiary analyses assessed the robustness of the results to alternative model specifications as well as effect modification by sociodemographics. Consistent with this prediction, there was statistical support for eight of nine potential serial mediation pathways via visit frequency which held for a range of alternative model specifications. Effect modification by financial strain, sex, age, and urbanicity altered some associations but did not necessarily support the idea that nature reduced health inequalities. The results demonstrate that across countries, theorised nature-health linkages operate primarily through recreational contact with natural environments. This provides arguments for greater efforts to support use of local green/blue spaces for health promotion and disease prevention.
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Affiliation(s)
- Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom.
| | - Tytti Pasanen
- Finnish Institute for Health and Welfare, Tampere, Finland
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom; Cognitive Science Hub, University of Vienna, Vienna, Austria
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom
| | - James Grellier
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom; Institute of Psychology, Jagiellonian University, Krakow, Poland
| | - Marta Cirach
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, USA
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Department of Forest and Conservation Sciences, Faculty of Forestry, University of British Columbia, Canada; School of Population and Public Health, Faculty of Medicine, University of British Columbia
| | - Anne Roiko
- School of Pharmacy & Medical Sciences, Griffith University, Australia
| | - Ann Ojala
- Natural Resources Institute Finland (Luke), Helsinki, Finland
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter, Cornwall, United Kingdom
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36
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Yang W, Yang R, Li X. A Canonical Correlation Analysis Study on the Association Between Neighborhood Green Space and Residents' Mental Health. J Urban Health 2023; 100:696-710. [PMID: 37535303 PMCID: PMC10447345 DOI: 10.1007/s11524-023-00756-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 08/04/2023]
Abstract
Based on survey data conducted in Guangzhou in 2021, this study employs canonical correlation analysis (CCA) to evaluate the relationship between neighborhood green space, residents' green space use behavior, and their mental health. The results show that compared with the objectively measured accessibility, residents' subjective perceived accessibility of neighborhood green space plays a greater role in promoting green space use behavior and mental health. Meanwhile, the plant diversity, safety, and the number of recreational facilities in a green space can promote the frequency of green space use, improve residents' mental health status and reduce their perceived stress. Although perceived accessibility is more related to green space use behavior than green space quality indicators, green space safety and recreational facilities have many more benefits on mental health than perceived accessibility. In addition, residents' green space use behavior, especially green space visit frequency, can promote mental health and reduce perceived stress.
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Affiliation(s)
- Wenyue Yang
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China.
| | - Ruyu Yang
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China
| | - Xin Li
- College of Forestry and Landscape Architecture, South China Agricultural University, Guangzhou, 510642, China
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37
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Ramli FF, Syed Hashim SA. The Health Argument of Climate Action during COP26: Commentaries on Mental Health Issues. Int J Med Sci 2023; 20:1163-1164. [PMID: 37575272 PMCID: PMC10416714 DOI: 10.7150/ijms.86368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 07/14/2023] [Indexed: 08/15/2023] Open
Affiliation(s)
- Fitri Fareez Ramli
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Kuala Lumpur, Malaysia
- Clinical Psychopharmacology Research Group, Department of Psychiatry, University of Oxford, Oxford OX3 7JX, UK
| | - Syed Alhafiz Syed Hashim
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Kuala Lumpur, Malaysia
- Institute of Pharmaceutical Science, King's College London, Franklin-Wilkins Building, 150 Stamford Street, London, SE1 9NH, UK
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38
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Bundo M, Preisig M, Merikangas K, Glaus J, Vaucher J, Waeber G, Marques-Vidal P, Strippoli MPF, Müller T, Franco O, Vicedo-Cabrera AM. How ambient temperature affects mood: an ecological momentary assessment study in Switzerland. Environ Health 2023; 22:52. [PMID: 37430261 DOI: 10.1186/s12940-023-01003-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/28/2023] [Indexed: 07/12/2023]
Abstract
BACKGROUND Recent research has suggested that an increase in temperature can negatively affect mental health and increase hospitalization for mental illness. It is not clear, however, what factors or mechanisms mediate this association. We aimed to (1) investigate the associations between ambient temperatures and bad daily mood, and (2) identify variables affecting the strength of these associations (modifiers) including the time, the day of the week and the year of the mood rating, socio-demographic characteristics, sleep quality, psychiatric disorders and the personality trait neuroticism in the community. METHODS Data stemmed from the second follow-up evaluation of CoLaus|PsyCoLaus, a prospective cohort study conducted in the general population of Lausanne (Switzerland). The 906 participants rated their mood level four times a day during seven days using a cell phone app. Mixed-effects logistic regression was used to determine the association between daily maximum temperature and mood level. Participant ID was inserted as a random effect in the model, whereas the time of the day, the day of the week and the year were inserted as fixed effects. Models were controlled for several confounders (socio-demographic characteristics, sleep quality, weather parameters and air pollutants). Stratified analyses were conducted based on socio-demographic characteristics, sleep quality, presence of psychiatric disorders or a high neuroticism. RESULTS Overall, the probability of having a bad mood for the entire day decreased by 7.0% (OR: 0.93: 95% CI 0.88, 0.99) for each 5 °C increase in maximum temperature. A smaller and less precise effect (-3%; OR: 0.97: 95% CI 0.91, 1.03) was found when controlling for sunshine duration. A higher association was found in participants with bipolar disorder (-23%; OR: 0.77: 95% CI 0.51, 1.17) and in participants with a high neuroticism (-13%; OR: 0.87 95% CI 0.80, 0.95), whereas the association was reversed for participants with anxiety (20%; OR: 1.20: 95% CI 0.90, 1.59), depression (18%; OR: 1.18 95% CI 0.94, 1.48) and schizophrenia (193%; OR: 2.93 95% CI 1.17, 7.73). CONCLUSIONS According to our findings, rising temperatures may positively affect mood in the general population. However, individuals with certain psychiatric disorders, such as anxiety, depression, and schizophrenia, may exhibit altered responses to heat, which may explain their increased morbidity when exposed to high temperatures. This suggests that tailored public health policies are required to protect this vulnerable population.
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Grants
- 801076 European Union's Horizon 2020 research and innovation programme
- 3200B0-105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468, 33CS30-148401, 33CS30_177535 and 3247730_204523 GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation
- 3200B0-105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468, 33CS30-148401, 33CS30_177535 and 3247730_204523 GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation
- 3200B0-105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468, 33CS30-148401, 33CS30_177535 and 3247730_204523 GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation
- 3200B0-105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468, 33CS30-148401, 33CS30_177535 and 3247730_204523 GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation
- 3200B0-105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468, 33CS30-148401, 33CS30_177535 and 3247730_204523 GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation
- 3200B0-105993, 3200B0-118308, 33CSCO-122661, 33CS30-139468, 33CS30-148401, 33CS30_177535 and 3247730_204523 GlaxoSmithKline, the Faculty of Biology and Medicine of Lausanne, the Swiss National Science Foundation
- 2018DRI01 Swiss Personalized Health Network
- 2018DRI01 Swiss Personalized Health Network
- 2018DRI01 Swiss Personalized Health Network
- 2018DRI01 Swiss Personalized Health Network
- 2018DRI01 Swiss Personalized Health Network
- 2018DRI01 Swiss Personalized Health Network
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Affiliation(s)
- Marvin Bundo
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | | | - Jennifer Glaus
- Department of Psychiatry, Division of Child and Adolescent Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Julien Vaucher
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), and University of Lausanne, Lausanne, Switzerland
- Department of Medicine and Specialties, Internal Medicine, Fribourg Hospital and University of Fribourg, Fribourg, Switzerland
| | - Gérard Waeber
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), and University of Lausanne, Lausanne, Switzerland
| | - Marie-Pierre F Strippoli
- Department of Psychiatry, Psychiatric Epidemiology and Psychopathology Research Center, Lausanne University Hospital and University of Lausanne, Prilly, Switzerland
| | - Thomas Müller
- Translational Research Center (TRC), University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Privatclinic Meiringen, Bern, Switzerland
| | - Oscar Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
- Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland.
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Csomós G, Borza EM, Farkas JZ. Exploring park visitation trends during the Covid-19 pandemic in Hungary by using mobile device location data. Sci Rep 2023; 13:11078. [PMID: 37422583 PMCID: PMC10329667 DOI: 10.1038/s41598-023-38287-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 07/06/2023] [Indexed: 07/10/2023] Open
Abstract
Sweeping changes in park visitation have accompanied the Covid-19 pandemic. In countries where governments imposed strict lockdowns during the first wave, park visitation declined in cities. The benefits of visiting urban green spaces on people's mental and physical health and well-being are generally acknowledged; many people in confinement during lockdowns reported increasing mental health issues. Therefore, based on lessons learned from the Covid-19 pandemic's first wave, urban parks and other urban green spaces remained open in most countries in subsequent pandemic phases. Furthermore, many studies have reported an overall increase in park visitation after strict lockdowns imposed in the pandemic's first wave have been removed. This study aims to investigate park visitation trends in Hungary based on a dataset of 28 million location data points from approximately 666,000 distinct mobile devices collected in 1884 urban parks and other urban green spaces in 191 settlements between June 1, 2019, and May 31, 2021. Findings demonstrate that park visitation increased in the inter-wave period of 2020, compared to the pre-pandemic period of 2019, and decreased in Waves 2-3 of 2021, compared to Wave 1 of 2020.
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Affiliation(s)
- György Csomós
- Department of Civil Engineering, Faculty of Engineering, University of Debrecen, 2-4 Ótemető út, Debrecen, 4028, Hungary.
| | - Endre Márk Borza
- CIAS, Corvinus University of Budapest, 8 Fővám tér, Budapest, 1093, Hungary
| | - Jenő Zsolt Farkas
- Centre for Economic and Regional Studies, Great Plain Research Department, 3 Rakóczi út, Kecskemét, 6000, Hungary
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40
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Zhong S, Lee C, Bian J, Towne SD, Lee H, Song Y, Li W, Ory MG. Environmental and Mobility Strategies During Early COVID-19: Insights From an Empirical Study Focusing on Park Visitations in El Paso, TX. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:61-82. [PMID: 37138470 DOI: 10.1177/19375867231166080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES We explored the importance of environmental and mobility strategies during early COVID-19 by age and ethnicity and investigated predictors of park visitations considering the COVID-19 impacts. BACKGROUND Parks are safe and accessible venues to stay active and reduce social isolation, which is especially important considering COVID-19 and the associated lockdowns. METHODS We analyzed online survey data from 683 residents (collected July 2020) of El Paso, TX, and objective measures of neighborhood park characteristics. Chi-square tests and mixed-effects logistic regression analyses were performed to examine the environmental/mobility strategies, personal and environmental factors, and park visitations, considering the COVID-19 impacts. RESULTS The percentage of those who visited (1+ times/week) parks or trails/paths in the neighborhood dropped from 41.7% to 19.5% since the start of COVID-19 (OR = 0.015, p < .001). Before COVID-19, middle-aged and older adults were less likely to visit parks than younger adults, while this difference became insignificant during early COVID-19. Hispanic adults were more likely to visit parks than non-Hispanics both before and during early COVID-19. Positive environmental predictors of park visitations included park availability in the neighborhood, proximity to the closest park, seeing people being physically active in the neighborhood, and neighborhood aesthetics. CONCLUSIONS Proximately located parks, trails, and paths well integrated into residential communities, and high aesthetic quality of the neighborhood are the potential features of pandemic-resilient communities and should be considered an important national priority to maintain and promote the health and well-being of the population, especially during pandemics like COVID-19.
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Affiliation(s)
- Sinan Zhong
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Chanam Lee
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Jiahe Bian
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Samuel D Towne
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Hanwool Lee
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Yang Song
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Wei Li
- Department of Landscape Architecture and Urban Planning, School of Architecture, Texas A&M University, College Station, TX, USA
| | - Marcia G Ory
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
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Carreño A, Fontdecaba E, Izquierdo A, Enciso O, Daunis-i-Estadella P, Mateu-Figueras G, Palarea-Albaladejo J, Gascon M, Vendrell C, Lloveras M, San J, Gómez S, Minuto S, Lloret J. Blue prescription: A pilot study of health benefits for oncological patients of a short program of activities involving the sea. Heliyon 2023; 9:e17713. [PMID: 37483694 PMCID: PMC10362171 DOI: 10.1016/j.heliyon.2023.e17713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 06/12/2023] [Accepted: 06/26/2023] [Indexed: 07/25/2023] Open
Abstract
Performing outdoor activities in blue spaces can help improve human health and mental well-being by reducing stress and promoting social relationships. The number of people surviving cancer has increased globally to experience this disease as a life-changing and chronic condition with physical and psychosocial symptoms that have negative impacts on their quality of life. While there has been a growth of programs in green spaces to meet the needs of cancer patients, such as follow-up post-treatment care, support groups and physical activity programs, very few studies have examined the effects of activities involving the sea for the health and well-being of oncology patients. This is the first study to evaluate whether different outdoor activities in blue spaces can benefit oncological patients' physical and mental health using smartwatches, sphygmomanometers and Profile of Mood States (POMS) questionnaires. We assessed changes in blood pressure, heart rate, sleep quality and mental health of 16 patients after twelve sessions of three different activities (walking, beach and snorkelling) and four sessions of a control activity. While no significant differences between activities were observed in terms of the data gathered by the smartwatches, a gradient of positive results for human mental health was observed towards exposure to a blue space, assessed through POMS questionnaires. Results show that exposure to blue spaces contributes to tension and anger reduction and improves the vigour mood state of oncology patients. No significant increases in patients' heart rate were recorded after the beach and snorkelling activities, with results similar to the control activity, suggesting that the contribution may be to participants' relaxation.
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Affiliation(s)
- Arnau Carreño
- Sea Health, Oceans and Human Health Chair, Institute of Aquatic Ecology, University of Girona, C/ Maria Aurèlia Capmany 69, 17003, Girona, Spain
| | - Eva Fontdecaba
- Medicina de Familia, CAP Castelló D’Empúries, Donostia-San Sebastian, Spain
| | - Angel Izquierdo
- Institut Català D'Oncologia, Hospital de Girona Dr. Josep Trueta, Avinguda de França S/n, 17007, Girona, Spain
| | - Olga Enciso
- Medicina de Familia, CAP Tossa de Mar, Corporació de Salut Del Maresme I La Selva, Girona, Spain
| | - Pepus Daunis-i-Estadella
- Dept. of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain
| | - Gloria Mateu-Figueras
- Dept. of Computer Science, Applied Mathematics and Statistics, University of Girona, Girona, Spain
| | | | - Mireia Gascon
- Barcelona Institute for Global Health (ISGlobal), Barcelona Biomedical Research Park (PRBB) Doctor Aiguader, 88 08003, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | | | - Joan San
- Sea Health, Oceans and Human Health Chair, Institute of Aquatic Ecology, University of Girona, C/ Maria Aurèlia Capmany 69, 17003, Girona, Spain
| | - Sílvia Gómez
- Dep. Social Anthropology, Autonomous University of Barcelona, Building B-Campus UAB, 08193, Bellaterra, (Cerdanyola Del Vallès) Barcelona, Spain
| | - Stefania Minuto
- Sea Health, Oceans and Human Health Chair, Institute of Aquatic Ecology, University of Girona, C/ Maria Aurèlia Capmany 69, 17003, Girona, Spain
| | - Josep Lloret
- Sea Health, Oceans and Human Health Chair, Institute of Aquatic Ecology, University of Girona, C/ Maria Aurèlia Capmany 69, 17003, Girona, Spain
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Garrett JK, Rowney FM, White MP, Lovell R, Fry RJ, Akbari A, Geary R, Lyons RA, Mizen A, Nieuwenhuijsen M, Parker C, Song J, Stratton G, Thompson DA, Watkins A, White J, Williams SA, Rodgers SE, Wheeler BW. Visiting nature is associated with lower socioeconomic inequalities in well-being in Wales. Sci Rep 2023; 13:9684. [PMID: 37322030 PMCID: PMC10272170 DOI: 10.1038/s41598-023-35427-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/17/2023] [Indexed: 06/17/2023] Open
Abstract
Natural environments can promote well-being through multiple mechanisms. Many studies have investigated relationships between residential green/blue space (GBS) and well-being, fewer explore relationships with actual use of GBS. We used a nationally representative survey, the National Survey for Wales, anonymously linked with spatial GBS data to investigate associations of well-being with both residential GBS and time in nature (N = 7631). Both residential GBS and time spent in nature were associated with subjective well-being. Higher green-ness was associated with lower well-being, counter to hypotheses (predicting the Warwick and Edinburgh Mental Well-Being Scale (WEMWBS): Enhanced vegetation index β = - 1.84, 95% confidence interval (CI) - 3.63, - 0.05) but time spent in nature was associated with higher well-being (four hours a week in nature vs. none β = 3.57, 95% CI 3.02, 4.13). There was no clear association between nearest GBS proximity and well-being. In support of the equigenesis theory, time spent in nature was associated with smaller socioeconomic inequalities in well-being. The difference in WEMWBS (possible range 14-70) between those who did and did not live in material deprivation was 7.7 points for those spending no time in nature, and less at 4.5 points for those spending time in nature up to 1 h per week. Facilitating access and making it easier for people to spend time in nature may be one way to reduce socioeconomic inequalities in well-being.
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Affiliation(s)
- Joanne K Garrett
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK.
| | - Francis M Rowney
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
- School of Geography, Earth and Environmental Sciences, University of Plymouth, Plymouth, UK
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
- Cognitive Science HUB, University of Vienna, Vienna, Austria
| | - Rebecca Lovell
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
| | - Rich J Fry
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Ashley Akbari
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Rebecca Geary
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Ronan A Lyons
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Amy Mizen
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Mark Nieuwenhuijsen
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Chrissie Parker
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | | | - Gareth Stratton
- Faculty of Science and Engineering, ASTEM Research Centre, Swansea University, Swansea, UK
| | - Daniel A Thompson
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - Alan Watkins
- Department of Population Data Science, Faculty of Medicine, Health and Life Science, Swansea University Medical School, Swansea University, Swansea, UK
| | - James White
- Centre for Trials Research, School of Medicine, Cardiff University, Cardiff, UK
| | | | - Sarah E Rodgers
- Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, UK
| | - Benedict W Wheeler
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro, UK
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Pasanen TP, White MP, Elliott LR, van den Bosch M, Bratman GN, Ojala A, Korpela K, Fleming LE. Urban green space and mental health among people living alone: The mediating roles of relational and collective restoration in an 18-country sample. ENVIRONMENTAL RESEARCH 2023:116324. [PMID: 37311473 DOI: 10.1016/j.envres.2023.116324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/15/2023] [Accepted: 06/02/2023] [Indexed: 06/15/2023]
Abstract
Rates of living alone, especially in more urbanised areas, are increasing across many industrialised countries, with associated increases in feelings of loneliness and poorer mental health. Recent studies have suggested that access to nature (e.g. parks and green spaces) can reduce the stressors associated with loneliness, partly through providing opportunities to nurture personal relationships (relational restoration) and engage in normative community activities (collective restoration). Such associations might vary across different household compositions and socio-demographic or geographical characteristics, but these have not been thoroughly tested. Using data collected across 18 countries/territories in 2017-2018, we grouped urban respondents into those living alone (n = 2062) and those living with a partner (n = 6218). Using multigroup path modelling, we tested whether the associations between neighbourhood greenspace coverage (1-km-buffer from home) and mental health are sequentially mediated by: (a) visits to greenspace; and subsequently (b) relationship and/or community satisfaction, as operationalisations of relational and collective restoration, respectively. We also tested whether any indirect associations varied among subgroups of respondents living alone. Analyses showed that visiting green space was associated with greater mental well-being and marginally lower odds of using anxiety/depression medication use indirectly, mediated via both relationship and community satisfaction. These indirect associations were equally strong among respondents living alone and those living with a partner. Neighbourhood green space was, additionally, associated with more visits among respondents living with a partner, whereas among those living alone, this was sensitive to the green space metric. Within subgroups of people living alone, few overall differences were found. Some indirect pathways were, nevertheless, stronger in males, under 60-year-olds, those with no financial strain, and residents in warmer climates. In conclusion, supporting those living alone, as well as those living with a partner, to more frequently access their local greenspaces could help improve mental health via promoting relational and collective restoration.
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Affiliation(s)
- Tytti P Pasanen
- Faculty of Social Sciences / Psychology, Tampere University, Kalevantie 4, 33014, Tampere University, Finland; Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland.
| | - Mathew P White
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK; Cognitive Science HUB, University of Vienna, Vienna, Austria
| | - Lewis R Elliott
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
| | - Matilda van den Bosch
- ISGlobal, Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; School of Population and Public Health, University of British Columbia, Canada; Department of Forest and Conservation Sciences, University of British Columbia, Canada
| | - Gregory N Bratman
- School of Environmental and Forest Sciences, University of Washington, USA; Department of Psychology, University of Washington, USA
| | - Ann Ojala
- Natural Resources Institute Finland (Luke), Finland
| | - Kalevi Korpela
- Faculty of Social Sciences / Psychology, Tampere University, Kalevantie 4, 33014, Tampere University, Finland
| | - Lora E Fleming
- European Centre for Environment and Human Health, University of Exeter Medical School, Knowledge Spa, Royal Cornwall Hospital, Truro, Cornwall, TR1 3HD, UK
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44
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Zahid U, Hosang GM, de Freitas DF, Mooney R, Bhui K. Ethnic inequality, multimorbidity and psychosis: can a syndemic framework resolve disputed evidence? SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:37. [PMID: 37296141 DOI: 10.1038/s41537-023-00367-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/02/2023] [Indexed: 06/12/2023]
Abstract
Syndemic theory is described as population-level clustering or co-occurrence of health conditions in the context of shared aetiologies that interact and can act synergistically. These influences appear to act within specific places of high disadvantage. We suggest ethnic inequality in experiences and outcomes of multimorbidity, including psychosis, may be explained through a syndemic framework. We discuss the evidence for each component of syndemic theory in relation to psychosis, using psychosis and diabetes as an exemplar. Following this, we discuss the practical and theoretical adaptations to syndemic theory in order to apply it to psychosis, ethnic inequality and multimorbidity, with implications for research, policy, and practice.
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Affiliation(s)
- Uzma Zahid
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | - Georgina M Hosang
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Daniela Fonseca de Freitas
- Department of Psychiatry, University of Oxford, Oxford, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Roisin Mooney
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Kamaldeep Bhui
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Nuffield Department of Primary Care Health Sciences, Wadham College, University of Oxford, Oxford, UK.
- Queen Mary University London Global Policy Institute, London, UK.
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45
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McCartan C, Davidson G, Bradley L, Greer K, Knifton L, Mulholland A, Webb P, White C. 'Lifts your spirits, lifts your mind': A co-produced mixed-methods exploration of the benefits of green and blue spaces for mental wellbeing. Health Expect 2023. [PMID: 37128668 DOI: 10.1111/hex.13773] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 04/17/2023] [Accepted: 04/18/2023] [Indexed: 05/03/2023] Open
Abstract
INTRODUCTION Mental health problems are a considerable public health issue and spending time in nature has been promoted as a way to access a range of psychological benefits leading to the development of nature-based interventions for people with severe and enduring mental health problems. Less, however, is understood about the potential benefits and efficacy of day-to-day routine access to outdoor green and blue spaces for mental health service users. METHODS Using a mixed-methods design between April and October 2021, we explored the benefits and barriers to spending time outdoors with a purposive sample of mental health service users (N = 11) using qualitative interviews and an online general population survey (N = 1791). Qualitative evidence highlighted the restorative benefits of nature and identified a number of barriers associated with fears around personal safety, social anxiety, fatigue and lack of motivation. COVID-19 had also restricted access to green and blue spaces. Having social contact and support encouraged people to spend time outdoors. In the quantitative survey, self-report and standardised measures (the Patient Health Questionnaire and the Warwick-Edinburgh Wellbeing Scale) were used to assess past and current mental wellbeing. FINDINGS Statistically significant differences were found between wellbeing and the use of green and blue spaces. Those with mental health problems spent time outdoors because they: felt guilty; wanted to reduce their anxiety; or rely on someone for encouragement. Those without mental health problems endorsed more positively framed reasons including relaxation, improving physical health or getting exercise. Barriers for people with mental health problems involved safety concerns, feeling anxious and having a poor self-image. These findings give insight into motivations for an outdoor activity to help inform the design of public mental health interventions. CONCLUSION Further work is required to improve access and safety to promote the benefits of green and blue spaces for everyone. PATIENT OR PUBLIC CONTRIBUTION The research team included expert experienced researchers with a mental health service provider (Praxis Care) and they were involved in the development of the research idea, funding application, design, data collection, analysis, writing up and dissemination activities.
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Affiliation(s)
- Claire McCartan
- Regional Trauma Network, IMPACT Research Centre, Northern Health and Social Care Trust, Antrim, UK
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
| | - Gavin Davidson
- School of Social Sciences, Education and Social Work, Queen's University Belfast, Belfast, UK
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Gomm S, Bernauer T. Are actual and perceived environmental conditions associated with variation in mental health? ENVIRONMENTAL RESEARCH 2023; 223:115398. [PMID: 36738773 DOI: 10.1016/j.envres.2023.115398] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/25/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE Empirical evidence on the relationship between environmental factors and mental health remains inconclusive. One reason is that there is only scant evidence on the association between mental health and subjective exposure to environmental stressors, relative to objective pollution. We thus focus on how the perceived and actual presence of noise, air pollution, and green spaces relates to mental health. METHODS AND RESULTS Our cross-sectional study is based on a large representative sample of the adult population in Switzerland (n = 5729). Using individual-level geocodes of subjects' residence, we combined data from a survey of these individuals with data on objectively measured longer-term environmental conditions (noise, air pollution, green spaces). Subclinical mental health was assessed with the 12-item General Health Questionnaire (GHQ-12). When fitting multiple regressions and mediation models, we find that perceptions of environmental stressors are a better predictor of mental distress than objectively measured stressors. In addition, the predictive power of actual nature visits is stronger than the predictive power of mere proximity to green spaces at the place of residence. We found no direct link between actual environmental stressors and mental health, but mediation via perceived environmental stressors. Further, the association between the frequency of nature visits and mental health is mediated by perceived, but not actual pollution. CONCLUSION Since actual environmental stressors are not perceived as equally burdensome by all people, their subjective perception is crucial when evaluating policy interventions aimed at improving mental health. Even a relatively low level of environmental stressors, classified as non-harmful to human health in a physical or biological sense, may thus contribute to negative mental health outcomes. The main policy implication is that attractive and accessible green spaces may provide individuals with an enhanced sense of control over their exposure to environmental stressors and thereby reduce negative impacts.
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Affiliation(s)
- Sarah Gomm
- ETH Zurich, Environmental Politics and International Political Economy, Haldeneggsteig 4, 8092, Zürich, Switzerland.
| | - Thomas Bernauer
- ETH Zurich, Environmental Politics and International Political Economy, Haldeneggsteig 4, 8092, Zürich, Switzerland.
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47
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M H, N B, L M, J W, J K, R T, T R, J B, H T, S H, B M. The environment a young person grows up in is associated with their mental health: A nationwide geospatial study using the integrated data infrastructure, New Zealand. Soc Sci Med 2023; 326:115893. [PMID: 37119566 DOI: 10.1016/j.socscimed.2023.115893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 03/19/2023] [Accepted: 04/06/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Mental health conditions often arise during adolescence, are multifaceted in aetiology, and may be related to the type of environment in which young people reside. This study used nationwide population-level data to investigate whether the environment a young person grows up in is associated with their mental health. METHOD Data were extracted from the Integrated Data Infrastructure (IDI), a large nationwide research repository, for 917,211 young people (aged 10-24 years) including sociodemographic and mental health data (i.e. emotional, behavioural, substance problems, and self-harm). Environmental data were sourced from the nationwide area-based Healthy Location Index (HLI), which has comprehensive data on the location of several health-constraining (i.e. fast-food outlets) and health-promoting features (i.e. physical activity facilities). Environments were classified as: i) health-promoting, ii) health-constraining, or iii) neither. Associations between the HLI and mental health were investigated using multi-level mixed effects logistic regression modelling. RESULTS Overall, there was evidence of an association between the environment a young person resided in and their mental health. Young people residing in health-constraining environments had higher odds of any mental health condition (Adjusted Odds Ratio (AOR) = 1.020 [1.001, 1.040]) and any emotional condition (AOR = 1.037 [1.012, 1.062]). Young people residing in health-promoting environments had lower odds of substance problems (AOR = 0.950 [0.905, 0.997]). There were no significant effects of the environment on behavioural conditions. CONCLUSION Our study utilises a large national sample of almost one million young people to confirm the importance of environmental determinants for mental health. It is possible that leverage points for improving the mental health of young people, and reducing the burden to the health system of mental health, can be sought in upstream environmental based interventions.
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Affiliation(s)
- Hobbs M
- Faculty of Health, University of Canterbury, Christchurch, Canterbury, New Zealand; GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand.
| | - Bowden N
- Department of Women's and Children's Health, University of Otago, Dunedin, New Zealand
| | - Marek L
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Wiki J
- GeoHealth Laboratory, Geospatial Research Institute, University of Canterbury, Christchurch, Canterbury, New Zealand
| | - Kokaua J
- Va'a O Tautai - Centre for Pacific Health, Health Sciences, University of Otago, Dunedin, New Zealand
| | - Theodore R
- National Centre for Lifecourse Research, University of Otago, Dunedin, New Zealand
| | - Ruhe T
- Va'a O Tautai - Centre for Pacific Health, Health Sciences, University of Otago, Dunedin, New Zealand
| | - Boden J
- Christchurch Health and Development Study, Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Thabrew H
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Hetrick S
- The Werry Centre, Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Milne B
- Centre of Methods and Policy Application in the Social Sciences, University of Auckland, Auckland, New Zealand
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48
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Rodriguez M, Kross E. Sensory emotion regulation. Trends Cogn Sci 2023; 27:379-390. [PMID: 36805103 DOI: 10.1016/j.tics.2023.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 02/17/2023]
Abstract
Decades of evidence reveal intimate links between sensation and emotion. Yet, discussion of sensory experiences as tools that promote emotion regulation is largely absent from current theorizing on this topic. Here, we address this gap by integrating evidence from social-personality, clinical, cognitive-neuroscience, and animal research to highlight the role of sensation as a tool that can be harnessed to up- or downregulate emotion. Further, we review evidence implicating sensation as a rapid and relatively effortless emotion regulation modality and highlight future research directions. Notably, we emphasize the need to examine the duration of sensory emotion regulation effects, the moderating role of individual and cultural differences, and how sensory strategies interact with other strategies.
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Affiliation(s)
- Micaela Rodriguez
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| | - Ethan Kross
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA; Ross School of Business, University of Michigan, Ann Arbor, MI, USA.
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49
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Macdonald L, Nicholls N, Gallou E, Monckton L, Mitchell R. Is spatial exposure to heritage associated with visits to heritage and to mental health? A cross-sectional study using data from the UK Household Longitudinal Study (UKHLS). BMJ Open 2023; 13:e066986. [PMID: 36990477 PMCID: PMC10069496 DOI: 10.1136/bmjopen-2022-066986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 03/12/2023] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVES Existing research highlights the beneficial nature of heritage engagement for mental health, but engagement varies geographically and socially, and few studies explore spatial exposure (ie, geographic availability) to heritage and heritage visits. Our research questions were 'does spatial exposure to heritage vary by area income deprivation?', 'is spatial exposure to heritage linked to visiting heritage?' and 'is spatial exposure to heritage linked to mental health?'. Additionally, we explored whether local heritage is associated with mental health regardless of the presence of green space. DESIGN Data were collected from January 2014 to June 2015 via the UK Household Longitudinal Study (UKHLS) wave 5. Our study is cross-sectional. SETTING UKHLS data were either collected via face-to-face interview or online questionnaire. PARTICIPANTS 30 431 adults (16+ years) (13 676 males, 16 755 females). Participants geocoded to Lower Super Output Area (LSOA) 'neighbourhood' and 'English Index of Multiple Deprivation' 2015 income score. MAIN EXPOSURES/OUTCOME MEASURES LSOA-level heritage exposure and green space exposure (ie, population and area densities); heritage site visit in the past year (outcome, binary: no, yes); mental distress (outcome, General Health Questionnaire-12, binary: less distressed 0-3, more distressed 4+). RESULTS Heritage varied by deprivation, the most deprived areas (income quintile (Q)1: 1.8) had fewer sites per 1000 population than the least deprived (Q5: 11.1) (p<0.01). Compared with those with no LSOA-level heritage, those with heritage exposure were more likely to have visited a heritage site in the past year (OR: 1.12 (95% CI 1.03 to 1.22)) (p<0.01). Among those with heritage exposure, visitors to heritage had a lower predicted probability of distress (0.171 (95% CI 0.162 to 0.179)) than non-visitors (0.238 (95% CI 0.225 to 0.252)) (p<0.001). CONCLUSIONS Our research contributes to evidence for the well-being benefits of heritage and is highly relevant to the government's levelling-up heritage strategy. Our findings can feed into schemes to tackle inequality in heritage exposure to improve both heritage engagement and mental health.
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Affiliation(s)
- Laura Macdonald
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - Natalie Nicholls
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | | | | | - Richard Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
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Müller H, Rehn-Groenendijk J, Wasmer A. Small-scale urban design interventions: A framework for deploying cities as resource for mental health and mental health literacy. Front Psychol 2023; 14:1112209. [PMID: 37020920 PMCID: PMC10067578 DOI: 10.3389/fpsyg.2023.1112209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/03/2023] [Indexed: 03/22/2023] Open
Abstract
With roughly half of the global population living in cities, urban environments become central to public health often perceived as health risk factors. Indeed, mental disorders show higher incidences in urban contexts compared to rural areas. However, shared urban environments also provide a rich potential to act as a resource for mental health and as a platform to increase mental health literacy. Based on the concepts of salutogenesis and restorative environments, we propose a framework for urban design interventions. It outlines (a) an output level, i.e., preventive and discursive potentials of such interventions to act as biopsychosocial resources, and (b) a process level, i.e., mechanisms of inter- and transdisciplinary collaboration of researchers and citizens in the design process. This approach aims at combining evidence-based, salutogenic, psychosocially-supportive design with a focus on mental health. Implementing low-threshold, resource-efficient options in the existing urban context brings this topic to the public space. Implications for the implementation of such interventions for citizens, researchers, and municipality stakeholders are discussed. This illustrates new directions of research for urban person-environment interactions, public health, and beyond.
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Affiliation(s)
- Helena Müller
- Department of Social and Cultural Sciences and Social Work, Darmstadt University of Applied Sciences, Darmstadt, Germany
- *Correspondence: Helena Müller,
| | | | - Anna Wasmer
- Department of Civil Engineering, Darmstadt University of Applied Sciences, Darmstadt, Germany
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